























































































































































































THE 


ECKELS-GENUNG METHOD 


A N I) 


Practical Embalmer 


A 

PRACTICAL AND COMPREHENSIVE TREATISE ON EMBALMING, 
TOGETHER WITH A COMPLETE DESCRIPTION 
OF THE ANATOMY AND CIRCULATION OF THE HUMAN BODY. 


EDITED BY 


HOWARD S. ECKELS, Philadelphia, Pa., 

Demonstrator on Practical Embalming. The Philadelphia 
Training School for Embalmers 


AXI) 


CHARLES 


A. GENUNG, Waterloo, 

Practical Undertaker and Embalmer 


N. Y. 




> 

> 

) 


> 

> > 


H. S. ECKELS & CO., inc. 

PHILADELPHIA, TA. 





LIBRARY of CONGRESS 
Two Copies Received 

JUN 11 1906 



COPYRIGHT, 1C06, 

By HOWARD S. ECKELS, Philadelphia, Pa. 
and CHARLES A. GEKUNG, Waterloo, N.Y. 






PREFACE. 


</? 


Embalming, as an art, has ..made greater progress in the 
last ten years than in the. previous one hundred years. 

As the knowledge of the Anatomist, combined with that 
of the Chemist, has been developed in a practical way in 
intelligently applying the proper chemicals, preservation of 
all human tissues has become..a possibility. 

With the newer and higher grade chemicals and the imple¬ 
ments to apply them, the practical embalmer can, with very 
little trouble, preserve the great majority of bodies with the 
least possible mutilation, and by experience, treat all and 
every condition so that preservation is not only thorough 
and complete, but the appearance of bodies so embalmed is 
most pleasing to the friends and relatives, as also is their 
knowledge of the embalmer’s scientific ability to prevent the 
spread of contagious and infectious diseases, and produce 
sanitary and hygienic conditions, removing the dread and 
horror which so frequently is felt in the presence of the dead. 

Recognition of the perfection and dignity of the art, grati¬ 
fying as it is, brings additional responsibilities and necessi¬ 
tates a wider and more scientific knowledge on the part of 
the embalmer. To be a success to-day, it is absolutely essen¬ 
tial for him to be familiar with the structure and anatomy 
of the human body. It is an irrefutable fact that if the 
embalmer is thoroughly familiar with the circulation of the 
blood during life, he is, according to the sequence of incon- 


III. 



IV. 


testible logic, familiar with the circulation and distribution 
of the antiseptic fluid which is injected into the same chan¬ 
nels for the purpose of preservation. 

In the following pages the Author has endeavored to give, 
in a plain and practical way, that knowledge of the construc¬ 
tion and functions of each part of the human frame which 
is essential to an intelligent following of the embalming 
profession. 

At first sight, the embalmer may say, ‘‘There is too much 
in this book to learn, too many details shown, and a great 
many things that do not apply to our business in particular.” 
Do not allow this idea to take possession of you. The time is 
here when the embalmer is frequently called on to evince a 
knowledge of even greater detail than is shown herein. The 
higher the general average of knowledge, the greater dig¬ 
nity and confidence will be reposed in the profession. 

Howard S. Eckels. 


PREFACE. 


The part I have taken in this work has been done with the 
desire that those who practice the methods advocated may 
have the assurance that they have done their work in a prac¬ 
tical and at the same time in the most scientific manner. I 
desire to call attention to what I believe to be the ‘‘funda¬ 
mental principles" of embalming, set down in Rules one 
and two. It is necessary that the reader understand these 
rules as thoroughly as he should understand the blood circu¬ 
lation. It is still further necessary that he shall become 
entirely familiar with the manner of work described in these 
rules, as reference will be made to them thioughout the 
entire work. I trust that all may be benefited by so doing 
as much as this line of procedure has benefited the author. 

Charles A. Genung. 


V. 



CONTENTS. 


PART FIRST. 

Instructions and Methods oe Embalming. 

By Howard S. Eckels. 

PART SECOND. 

Instructions and Methods oe Embalming. 

By Charles A. Genung. 

PART THIRD. 

Specific Instructions for Beginners. 

PART FOURTPI. 

The Embalmer’s Guide. 


VI. 



INDEX. 


Arteries, Description of .128, 201 

Pulmonary . 129 

Aorta . 130 

Blood-Vessels of the Brain. 136 

Arteries of the Upper Extremity. 136 

Arteries, How to Locate, Raise and Inject. 20 

Axillary . 20 

Brachial . .. 29 

Right Common Carotid. 22 

Femoral . . ... 34 

Posterior Tibial . 

Radial . 39 

Arteries, Suggestions and Cautions in the Selection of. . 15 

Common Carotid . 15 

Axillary . 17 

Brachial . 18 

Arterial Embalming, General Direction for.40, T09 

Arterial Embalming Complete, or How to Embalm a 

Body Thoroughly . 112 

Artery for Injection, Selection of. 112 

Aorta . 130 

Appendicitis Cases, Embalming of. 99 

Apoplexy Cases .61, 95 

Action of Embalming Fluid. 84 

Autopsied Bodies . 9 1 

Abdomen . 189 


VII. 



























Blood Circulation .127, 203 

Blood, Why Draw. 79 

Blood Formation and Circulation. 201 

Blood Vessels of the Brain. 136 

Brain and Its Membranes.181.235 

Body and Extremities. 212 

Bladder . 194 

Broken Neck Case, or Strangulation, Embalming ot. .63 

Cavity Embalming . 115 

Cranial Method of Embalming. 88 

Consumption, How to Embalm a Case. 42 

Child-birth Cases, Embalming of.56, 100 

Cancer Cases, Embalming of. 101 

Children’s Cases, Embalming of. 104 

Color, Life-like . 92 

Contagious Diseases. 124 

Circulation .127, 203 

'‘Discoloration’’ . 65 

Difficult Cases, Special Treatment of. 41 

Dropsy Cases, Embalming of.50, 86, 101 

Drowning Cases, Embalming of. 59 

Disinfection of Dead Bodies.67, 93 

Disinfection for Long Time Preservation. 84 

Disinfecting Rooms . 125 

Amount of Solution Required. 126 

Draining Tube, How to Insert. 76 

Diaphragm . 194 

Embalming, Long Time. 119 

Embalming Fluid, Action of. 84 

Embalming, Fundamental Rules of. 88 


VIII. 































Eye . 244 

Ear . 246 

Embalmer’s Guide. 127 

Funeral Etiquette . 104 

Gun Shot Wound Cases, Embalming' of. 58 

Gangrene Cases, Embalming of. 101 

Gall Bladder . 192 

Head . 231 

Heart . 184 

Hemorrhage Cases, Embalming of.49, 100 

Hollow Needle, Injury to the Circulation Done by Using 

It . 82 

Injection by Gravitation. 72 

Infectious Diseases . 124 

Intestines . 187 

Injection of Fluid, Injection of More Than One. 102 

Instructions and Methods of Embalming.13, 67 

Kidneys . 193 

Liver . 19° 

Lungs . i8 5 

Nervous System . 205 

Cranial Nerves . 206 

Spinal Nerves . 205 

Spinal Cord . 208 

Sympathetic System. 207 


IX. 


























Operations, Death Following. 9 ^ 

Oesophagus . J 83 

Pneumonia, How to Treat a Case Dying from.45, 100 

Peritonitis Cases, Embalming of.57, 99 

Post-mortem Cases, Embalming of. 64 

Paralysis Cases, Embalming of. 95 

Position of Body While Being Embalmed. 94 

Portal Venous System . 179 

Portal Circulation . 203 

Pharynx . 183 

Pancreas . 19 2 

Pleurisy Cases. 46 

Rules for Procedure When Embalming. 88 

Specific Instructions for Beginners. 109 

Systemic Circulation . 203 

Skeleton . 196 

Stomach . 186 

Spinal Cord . 208 

Skull . 231 

Sarcoma Cases, Embalming of. 101 

Spleen . 192 

Scalp, etc. 231 

Strangulation, or Broken Neck Cases, Embalming of. . 63 

Suffocation Cases, Embalming of. 63 

Sunstroke and Heat Cases, Embalming of.46, 100 

Special Cases, Treatment of.41, 98 

Specially Prepared Fluid for Dropsy Cases. 102 


X. 




























Typhoid Fever and Low Type Fever Cases, Embalming 


of . 48 

Tuberculosis Cases, Embalming of. 98 

Time After Death for Embalming the Dead. 92 

Thorax . 183 

Uremia Cases, Embalming of. 96 

Veins, Description of, etc.164, 202 

Axillary Win .94, 172 

Pulmonary Veins . 165 

Abdominal Veins . 177 

Cardiac Veins . 180 

Deep Veins of Upper Extremity. 171 

Deep Veins of Lower Extremity. 176 

Jugular Veins .94, 167 

Portal Venous System. 179 

Systemic Veins . 166 

Superficial Veins of Upper Extremity. 169 

Superficial Veins of Lower Extremity. 175 

Spinal Veins . 174 

Veins of the Shoulder and Chest. 172 


XI. 





















LIST OF ILLUSTRATIONS. 


PART FIRST. 


Page. 

Author's Portrait .Frontispiece 

Reproduction of Original Arterial System. 13 

Incision for the Carotid Artery (either one or both) ... 21 

The Right Carotid Artery. 27/ 

Both Carotid Arteries (one incision O/2 inches long) ... 33/ 

Injecting Axillary Artery; Draining Blood from Axil¬ 
lary Vein Through Spiral Vein Tube. 39 

Injecting Carotid Artery (Nearly Finished) : Aspirating 
Blood Through Cardiac Needle from the Superior - 

Vena Cava .r. 45 J 

External Iliac Artery . 59 / 


PART SECOND. 

Holding the Vein Open with Vein Forceps Preparatory 

to Inserting the Genung-Eckels Draining Tube. ... 71 

The Genung-Eckels Draining Tube Entered Into the Ax¬ 


illary Vein . Ss 4 

Gravitating Fluid Into the Axillary Artery in Both Di¬ 
rections, and Draining Blood with the Genung- 

Eckels Draining Tube . 91 

The Genung-Eckels Draining Tube, Extending Beyond 

the Valves in the Subclavian Vein. 97 


PART THIRD. 
Formaldehyde Lamp . 


1 2f> 


PART FOURTH. 

Transverse Section in “Middle Third ’ of Arm, Where 

the Brachial Artery is Usually Raised. 135 

Transverse Section of the Neck in Region Where the 

Carotid Arteries are Raised. 

Organs of the Thoracic and Abdominal Cavities. 179 

Transverse Section of the Leg in the Region Where the 

Femoral Artery is Usually Raised. 193 / 


XII. 

















PART FIRST. 


Instructions and Methods or Embalming. 

By Hozvard S. Eckels. 


Reproduction of Original Arterial System. 



The human heart and great blood vessels with the entire 
arterial system. Dissected and diagrammatically mounted in its 
full size by H. S. Eckels. The only specimen in the United 
States. Just finished. The first exhibit. 















PART FIRST. 


Instructions and Methods of Embalming. 

By Hozvard S. Eckels. 

In contrast with the usual treatise on this subject, we begin 
at once a condensed or advanced Post Graduate course of 
instruction for the Undertaker already engaged in the busi¬ 
ness, and the Embalmer who has had a preliminary training 
and practical experience in embalming. It is, in reality, pre¬ 
pared for the up-to-date man—the busy man—on the lines 
of specific treatment for the difficult, unusual, and peculiar 
cases met with in everyday practice; and while a “head full 
of good common sense” is the most essential feature, in con¬ 
junction with this, a realization that the circulation of the 
blood during life, through its arteries, conveys the blood to 
the tissues, guides the Embalmer in his distribution of the 
fluid through each and every artery, to reach all parts of the 
body. 

The arteries of the systemic circulation (that which the 
Embalmer universally uses) begin at the left ventricle of the 
heart, at the semilunar valve. This valve, which controls 
the blood circulation in life, also controls the circulation of 
fluid in embalming, forming, as it were, a water back that 
holds the fluid in the arteries, and, when they become full, 
forces it on through the capillaries to the lymphatics, and 
surely into the veins if the process of injection is continued 
without obstruction. As circulation existed in life, it is well 
to bear in mind the logical conclusion that wherever this 


13 


14 


circulation lias been in evidence, there the circulation 
of the fluid may be readily and easily obtained 
with proper application and care. It is never a good argu¬ 
ment, particularly to yourself, that “circulation is not to be 
obtained,” for the fact is that the channels do exist, and 
circulation may be had always, though not always m the 
same way. 

The object of embalming the dead is obvious. It is the 
only means of keeping a body for an indefinite time, and of 
knowing that it will retain its life-likeness. It further pre¬ 
vents all obnoxious odors and gases from arising, rendering 
the atmosphere wholesome, and the body beautiful in the 
eyes of the relatives and friends, and as the embalming fluid 
contains antiseptic properties, a great health preserving serv¬ 
ice is at the same time rendered to the public. 

Embalming seems to the ordinary mind a mysterious 
application of a difficult science. A thoroughly skilled Em- 
balmer, with his intimate knowledge of the human body,, 
properly steps into a higher position than an ordinary Under¬ 
taker. You enter the house of the dead like a physician, 
with your cabinet of instruments, and proceed to do your 
beneficent work and to maintain your position and the dignity 
of your profession. It is essential that you should treat a 
body with intelligence and care, and assume a responsibility 
which requires your further attention, being ready to take 
care of the conditions as they arise, the successful treatment 
of which marks your success. 

We wish to call your attention to the Anatomical Aid and 
Manikin Chart. The Anatomical Aid is a valuable appliance, 
as a reference to the Manikin Chart, which shows all of the 
trunk arteries, veins, organs, and the entire anatomy of the 
body, which guides the student and enables him at all times 
to see exactly what he is doing. 


Lying directly over the muscles in the body section of the 
Anatomical Aid, the skin plate affords many advantages, as 
it enables you to see their true relation to the skin surface, 
which is quite important when introducing the needle or 
trochar. The organs as represented in the Anatomical Aid 
correspond with the size of this body; so, to find any par¬ 
ticular spot on the body on which you are operating, simply 
take the length and breadth of the trunk (or body) and 
allow for the difference in size. You can thus locate exactly 
the organ or spot required, and avoid penetrating arteries. 

Never work too hurriedly, and always watch the object, 
for in some cases damage may occur by rupturing an artery. 
However, this happens rarely, as the arteries are very tough 
and elastic, yet it is advisable never to inject fluid too rapidly. 
A gradual and steady flow is best obtained by gravitation, 
and when embalming fluid is injected in this manner, no 

difficulty will be experienced. 

About one to two hours should be devoted to embalming 
a body, the time given depending upon its condition, size, 
weight, how long dead, and the length of time to elapse be¬ 
fore interment. 

SUGGESTIONS AND CAUTIONS IN SELECTION OF 
ARTERIES FOR INJECTION. 

COMMON CAROTID ARTERY. 

To professional embalmers one of the most important ar¬ 
teries is the Common Carotid (i, Blood Formation). Its 
advantages are that it is large enough to admit almost any 
size tube; it is very easily located and raised; it carries the 
fluid injected into it, and passes directly into the large ar¬ 
teries and distributes freely throughout the entire arterial 
system ; it has the great advantage of the most direct circula¬ 
tion to the face, especially when you are injecting 


towards the head. The majority of embalmers pre¬ 
fer to inject the Carotid artery downward first, be¬ 
cause the opposite side of the face receives its 
quota of fluid through the Carotid artery on that side, and 
the complete and satisfactory evidences of perfect circulation 
there indicate to the observing embalmer when sufficient fluid 
has been injected. At this point the injection of the fluid is 
close to the center, or beginning of the circulation, the heart, 
and the more direct the circulation the greater the certainty 
of success. But the very greatest advantage is from inject¬ 
ing by direct circulation the exact quantity of fluid desired in 
the face tissue, this being the exposed part of the body. It 
matters little what kind of case is to be injected, this free, 
thorough circulation proves the greatest satisfaction in em¬ 
balming. 

In coloration produced by the presence of blood, the wash¬ 
ing of this blood from the capillaries and tissue is most cer¬ 
tain by the direct injection through the arteries, washing it 
from' the capillaries into the veins. It is a mistake to fear 
that a reasonable amount of fluid injected in this way will 
over-embalm a body. The appearance of over-embalming 
most frequently occurs from the contact of blood in the tis¬ 
sue with the fluid, which, remaining there, causes not only 
the discoloring of the walls of the capillaries and the sub¬ 
stance of the tissue, but also toughening and drying of the 
tissue by the fluid, whereas, had the fluid circulated freely, 
washing thoroughly and altogether clear from the tissue the 
blood which caused the coloration, then the firm, dry, clear, 
waxy appearance of the flesh tissue would be natural and 
altogether desirable. 

In many cases, after injection downwards through the 
Carotid artery, an injection upwards through the other end 
of the artery (in the same incision) insures success. In 


i7 


cases like Consumption, Typhoid Fever, Aneurisms, Rup¬ 
tures, Lesions of any kind which would be subject to a leak¬ 
age from the general circulation, both Carotid arteries should 
be injected upwards, as the injection of the Brachial or 
Femoral arteries, would fail, on account of leakages in gen¬ 
eral circulation, to drive the fluid satisfactorily from the 
arteries of the trunk of the body up to the face. 


ti-ie: axillary artery. 

To the progressive, “up to the minute” embalmer, the 
axillary artery offers the greatest advantages in embalming 
bodies for the present day funeral, where the appearance of 
the embalmed body indicates the character and considerate 
qualifications of the able funeral director and the painstaking 
skill of the embalmer. All logical reasonings offered on 
embalming have been based upon the blood circulation pre¬ 
vious to death. This being true, it is at once apparent to all, 
that when the embalmer delivers the injected fluid at once 
to the beginning of the systemic circulation, the ascending 
Aorta, by the Axillary arterial tube from whence the embalm¬ 
ing fluid radiates towards every extremity in the exact 
proportion which was natural to the circulation during 
life; thus the four trunk arteries leading to the head will 
convey the proper quota of fluid for its perfect preservation 
and produce the most natural appearance. With this method 
of injection, the body need no longer be laid flat for the pur¬ 
pose of “even distribution”, sacrificing one of Nature’s laws 
in gravitating the blood from the face and neck. Instead, 
the body is placed in an easy, comfortable appearing incline, 
to allow the blood to drain from the neck and face. 
This will aid the free circulation of the embalming fluid, 
which is radiated through the arteries of the upper trunk 
and which fluid being delivered clear and without blood con- 


i8 


tamination to the very origin of the branches of the arch 
of the Aorta, the carotids of the head, and the subclavian 
to the hands; thus all of these exposed parts of the body are 
cared for in the most scientific and common-sense way yet 
devised in embalming. 

The Axillary artery is now used almost entirely by some 
embalmers when injecting bodies. Many claims may be 
made in favor of its use, and some important ones are: It 
is always very superficial, always of large diameter; within 
it fluid is passed only a short distance before it is emptied 
directly into the aorta, this being very desirable in all cases. 

The axillary vein can be raised from this same incision, 
being the best and most convenient vein of the body from 
which blood may be drawn. Surely no reasonable objec¬ 
tions can be advanced to an embalmer making this one 
incision in the axilla, as there is no objectionable exposure 
and the least noticeable mutilation; while the results that 
may be obtained are always desirable, and thoroughly sci¬ 
entific. 

In cases where the systemic circulation is intact, all may 
be accomplished by using this artery, that may be bv using 
any other. 

The axillary artery and axillary vein can be raised easier 
than any equally large ones, for even on very stout bodies 
they are quite superficial and always easily reached, and 
may be operated on in a neat manner in all cases, provided 
the embalmer uses the improved, up-to-date, axillary artery 
and axillary vein tubes. 

BRACHIAL ART CRY. 

Not the least important artery for embalming purposes is 
the Brachial artery, situated in the arm. Being of good size, 
it is capable of receiving a large-sized tube in its canal. 


This artei \ is used in many cases of embalming - with the 
best success, its location admitting of its use at any time in 
female as well as in male subjects. 

It is eas\ to hud on account of its landmarks, the borders 
of the biceps and triceps muscles; it is more superficial than 
any of the others that are used, excepting the Radial and 
Axillary arteries, and it receives the fluid easily and readily. 

The arm being directed outward in a horizontal direction 
gives the course of the brachial almost straight to the arch of 
the aorta, through the Axillary and Subclavian arteries, the 
Vertebral and Common Carotid receiving the fluid on its 
course, and carrying it to the face, head and brain, passing 
around the circle of Willis, and supplying the numerous 
branches which are given off in their locations, thus embalm¬ 
ing the upper and lower extremities at one and the same 
time. Thus it is evident that embalming through the Brachial 
artery often has great advantages. 

The superior and inferior profunda of the Brachial fre¬ 
quently carries fluid to the arm and hand, but while it is a 
fact that in a majority of people these arteries connect or 
anastomose with the Radial and Ulnar arteries and carry 
blood freely through these during life, yet in morbid anatomv 
in its passive condition the circulation does not by the recur¬ 
rent force convey fluid sufficient and with pressure enough 

to drive the same to the extremities of the smallest arteries, 
the capillaries, and as a result you often find “skin slip” and 
signs of decomposition. This occurs particularly in the sum¬ 
mer time, and on the arm and hand of dropsical cases, where 
the Brachial has been used only towards the trunk in em¬ 
balming; therefore, on such cases it is advisable, after in¬ 
jecting towards the trunk of the body all of the fluid which 
is needed there, to reverse the tube in the Brachial artery, in¬ 
jecting a few bulbfuls towards the hand, sufficient to pre- 


20 


serve the tissue there. This is also of the greatest benefit in 
removing discoloration from the hands and fingers under the 
nails, when same occurs from congested blood. While in¬ 
jecting this way great benefit follows from manipulation 
there with the hands or with a soft sponge made moist. This 
stimulates the circulation of the fluid to the surface lymphat¬ 
ics and tissue, so that even on the worst dropsical cases no 
blisters or slipping of skin will ever occur. 

HOW TO LOCATE, RAISE AND INJECT ARTERIES. 

AXILLARY ARTERY. 

The axillary artery is most desirable for many reasons. 
It is superficial, being closer to the surface than any other 
equally large artery. It is well hidden by the position of 
the arm, which is folded over the body and thus is protected 
from the view of any specially curious member of the fam¬ 
ily. It exists in the arm pit, the incision for the Axillary 
being made in the hair line, which is still more obscure than 
when the artery is selected farther down the arm. Its course 
is marked by the continued depression which exists between 
the biceps and triceps muscles. 

The axillary artery is found immediately beneath the 
median nerve. On account of the size of the artery, it is 
more easily found and distinguished better from the axillary 
vein, than is the brachial artery from the basilic vein. 

To raise the artery, place the arm at right angles with the 
body. The incision should be made carefully and not too 
deep, as this artery is found close to the surface. Start the 
incision close to the trunk of the body, extending the cut 
downward over the course of the artery, through the skin 
and fascia.. Very little fat tissue exists here, even in the 
stoutest people, hence this is always an easy artery to raise. 
Make the incision about an inch and a half to two inches in 
length. Frequently the vein makes its appearance first. The 











21 


blood in the vein shows dark, and by pressing upon the 
tissue on the hand side of the incision, you will readily force 
the blood towards the trunk of the body, expanding the vein, 
so that it is easy of recognition. The artery is found nearer 
the front or upper portion of the arm and beneath the nerve, 
and in a sheath associated with one or two small veins, the 
nerve and tendon. Separate these and select the ax¬ 
illary artery. You will be able to determine between the 
artery and the nerve by pressing on the arm over the artery 
towards the incision, thus collecting the blood in the artery, 
which will fill, and so indicate it from the nerve. This is 
more easily noticed when a slender instrument (aneurism 
hook) is used instead of the finger in raising up the artery 
and nerve, because too much pressure beneath the artery will 
prevent the distension and circulation of blood through it 
which has thus collected. In all normal conditions, an easy 
comparison is made between the artery and the vein. The 
artery should have two ligatures placed around it, one to¬ 
wards the hand being tied to prevent leakage. The artery 
should then lay flat on the bone separator, the artery being 
tapped by the use of the scalpel, and the axillary artery tube, 
which should be long enough to pass into the artery all of 
the way to the arch of the aorta. When this has been accom¬ 
plished, the ligature should be tied around the arterial tube, 
which, if of the proper sort, will permit of the single knot 
to hold it and to prevent leakage. Thus when the tube is re¬ 
moved this knot is easily drawn tight. This is cpiite a conven¬ 
ience to the operator. The tube should be reversed in the ar¬ 
tery, or else a two-way tube should have been used, so that 
with turning the valves, an injection of a half pint ot fluid 
may be made in the arm towards the hand, thus properly 
embalming it and clearing all discoloration from the finger 
tips and from beneath the finger nails. 


22 


The selection of this artery at this point and with the 
axillary arterial tube conveying fluid directly into the aorta, 
does not cause the rigid condition of the arm which usu¬ 
ally occurs when injecting fluid into the brachial artery. 
Hence, when you have finished the arterial injection, the 
arm and hand may be placed over the body with ease and 
in the position which is desired at the time of the funeral. 

Fluid should be injected into the axillary artery and con¬ 
tinued until the usual positive signs of thorough circulation 
and disinfection of the body have been obtained. (See rules 
page 88.) 

The greatest advantage of the axillary artery in the injec¬ 
tion of fluid is that you deliver your fresh (uncontaminated 
with blood) fluid directly into the arch of the aorta, where 
the common carotid arteries branch from it, thus delivering 
this clear fluid into the face, forcing all of the blood there¬ 
from through the capillaries into the veins, which, draining 
from the head and neck through the several jugular veins, 
all empty both directly and indirectly into the innominate 
veins. Indeed, all of the veins of the upper trunk of the 
body drain directly to this point, and is reached through the 
axillary vein, which accompanies the axillary artery, and 
with the arm in the position as described for raising and 
injecting the axillary artery, the newest and most approved 
vein tubes may be used in this axillary vein to drain the blood 
from the innominate veins, thus providing perfect circulation 
of fluid through the tissue while draining the blood con¬ 
stantly and thoroughly from the body. 

RIGHT COMMON CAROTID ARTERY. 

(i, Blood Formation, and 19, Head Plate.) 

First as to its location. It is a branch of the arteria inno- 
minata (2, Blood Formation), and arises from behind the 


right sterno-clavicular articulation, and proceeds in a direct 
line to the upper border of the thyroid cartilage, about oppo¬ 
site the angle of the jaw bone, where it divides into the ex¬ 
ternal and internal carotids. The direct course, then, of the 
Right Common Carotid artery is from the sternal end of the 
clavicle (5, Rib Plate) to the mastoid process, a point indi¬ 
cated by the lower lobe of the ear. 

To raise this artery for embalming purposes, mark out a 
line as indicated, and choose for the point of incision its 
lowest part, as near the clavicle (collar bone) as possible. 

Make an incision directly on a line across the center of the 
body at the upper end of the sternum bone, between the 
angle or articulation of the right and left clavicle. This will 
enable you to take up either the right or left Carotid artery, 
and it may be desirable to use both of them for the injection 
of the head, in the event that the body is posted, or that an 
aneurism or leakage is discovered, or when injecting down¬ 
wards a flushed condition of the face occurs and the blood 
may not be readily drained away, or in cases where conges¬ 
tion of the blood has occurred one or more days previous. 
Direct circulation always has advantage over general circu¬ 
lation, inasmuch as all of the fluid injected is conveyed to 
this extremity, instead of only a small proportion; this incis¬ 
ion admits of raising either or both of these arteries, which 
frequently is most desirable. 

The Lineal Guides there are the group of muscles which 
we term the Mastoid muscles—these on the outside, and the 
trachea, or windpipe, on the inside,—direct your forefinger, 

which is used to separate the superficial as well as deep- 
seated fascia, and directing the finger towards the head, in¬ 
stead of towards the body, soon guides it immediately on 
top of the Carotid artery. 

Some care should be observed not to rupture the jugular 


24 


vein, which lies immediately beneath those muscles, and with 
such care the Carotid artery may be brought to the surface 
through an incision not longer than I or i y 2 inches at the 
most, without causing any rupture of the veins, which would 
give immediate annoyance. 

Special attention should be given in your first efforts in 
raising the Carotid artery to realize that while with your 
forefinger you have separated the deep fascia surrounding 
it on the top, and perhaps on the sides, you have not done 
this on the lower side, and that your aneurism needle, which 
is of great assistance to you in raising this artery, pushes 
through this fascia on the lower side; but this only admits 
of your drawing the artery up by pressing away the tissue 
with your forefinger, while with the hook in the other hand 
you separate and push away this fascia, gradually allowing 
the artery, which is on your hook, to come through to the 
surface, and so continue until you can pass your finger and 
instrument beneath the artery, when with your blunt-end 
aneurism needle you can separate the tissue off the outside 
of the artery until it comes out clear and clean and the 
artery alone is separated from all of the adhering tissue. As 
the artery is flexible, particularly so at this region, you will 
find it will come to the surface freely and easily, and be 
accessible for injection in both directions. 

Raising the artery at this point, pass two pieces of silk or 
string under it, one piece at the lower, the other at the 
upper end, as it lies in position for making your incision, 
with bone or rubber separators placed under it. 

Make an incision into the artery about its middle, suffi¬ 
cient in size for the- insertion of your tube or nozzle. This 
puncture or incision is to be made for this one purpose, i. e., 
the introduction of the nozzle in question, and should be 
made with special reference to its size. The easiest, quick- 


est, and surest way of making this incision is to raise the 
artery over a separator or a piece of wood, and enter the 
point of your sharp scalpel on the edge of the artery far 
enough to make the incision to get the opening necessary. 
In this way you cut the three coats clear and clean, and 
have no difficulty in getting into the canal, nor danger of 
severing your artery in twain, an accident which would make 
bad work, as the elasticity of the artery carries the severed 
ends out of sight at once, and you are forced to seek them 
with much painstaking—the one part far up in the neck, and 
the other part in an opposite direction. . 

Too much care cannot be used in this simple little opera¬ 
tion of the incision. Be sure the incision penetrates the 
canal of the artery, as it happens occasionally by the longi¬ 
tudinal cutting that the cut only reaches through the first 
or second coat or tunic. In such a case there is trouble 
again, for the operator is no better off with only the first and 
second coat penetrated than as if no incision had been made. 

Another test which 1 invariably use is to first introduce 
the director, or fascia needle, a little instrument which is half 
curved, has a crevice, and also a flat end, which enters the 
artery very easily and shows definitely whether the incision 
is made of sufficient size. This instrument is used as a pro¬ 
tection against the blunt end of the embalming tube, and 
should always accompany it, placed with the crevice down 
so as to direct the artery tube. It is about six inches in 
length. Place the director in the canal down towards the 
body, and allow it to enter as far as possible. Usually, on 
withdrawing it, a few drops of blood will follow, thus afford¬ 
ing a sure, easy test. 

After you are positive you have made a true incision, in¬ 
troduce your director into the artery, lifting it towards >011 a 
little, thus opening the incision to admit of an arterial nozzle. 


26 


In this way you will not push down one of the inner coats of 
the artery, which is occasionally done, particularly in Bright’s 
Disease cases. 

After entering arterial tube directed towards the body, 
introduce one directed towards the face. Ligate both tubes 
securely. 

When the tubes are properly in the canals, securely fast¬ 
ened, and all in readiness, proceed to inject fluid with ordi¬ 
nary dispatch. 

While your fluid is flowing towards the body, and going 
into the general circulation, which is divided through so 
many of the branches from the aorta, the only caution the 
operator need observe is that the fluid is being circulated 
evenly all over the body. This may be aided materially by 
manipulation, either with the hands or with a wet sponge. 
Rubbing well will quickly develop capillary circulation which 
will surprise the novice, showing great benefit to be derived 
from it, and while this does not attract the attention of the 
operator to any great extent on the majority of cases, it is 
highly important that we undersand its possibilities, because 
on bad cases this manipulation may be used with great suc¬ 
cess, particularly with blood congestion or coloration of face, 
hands, or arms. 

Continue the injection until you think sufficient fluid has 
been used. The rule, on ordinary cases, is to use a quart of 
fluid to every 50 lbs. Thus on a body of 200 lbs. a gallon of 

fluid would be used arterially. Observe closely the super¬ 
ficial veins, such as the temporal and facial veins. Should 
they raise or bulge under the strain, this is positive proof 
that the entire venous system is distended, and that blood 
should be drained therefrom. 

After a few minutes, perhaps five, continue the injection 
until you have used the needed amount. Three quarts will 



















% 













•l-' 








































THE RIGHT CAROTID ARTERY, 







27 


be ample in the average case of 150 lbs. I have injected, 
and have seen others inject, a much larger quantity; but 
ordinarily, where only a few days’ preservation is desired, 
the above amount will be sufficient. Still, the operator’s 
judgment must be the arbiter throughout. 

When the injection is complete, remove the nozzle and tie 
up the end leading towards the body. Loosen the other liga¬ 
ture (which should have been made with only a single knot, 
tied with a fairly good sized cord, so that it would not cut 
through the inner wall). 

The director may again be used, and the arterial nozzle 
entered towards the face. Here great care is necessary to 
obtain the best results. Just enough fluid should be injected 
—from 3 ounces to a pint may be used—but from the very 
beginning the closest observation should be made, as swell¬ 
ing of the eyes or face can very easily and quickly result from 
this direct injection. This, of course, would change the 
countenance and expression. It is easy to see this, however, 
if the operator is watching, and the first intimation of it is 
conclusive proof that sufficient fluid has been injected 
therein. 

If this produces a nicer, or whiter and more waxy appear¬ 
ance than exists on the opposite side of the face, it is best 
that the operator, through the same incision made to raise 
this artery, should raise the Carotid artery on the other side 
and inject it with a like amount of fluid, to obtain like re¬ 
sults. 

As formerly stated in cases of flushing, this is positively 
sure of removing it, particularly if the blood is relieved from 
the Vena Cava, thus draining all the veins which run into it. 
This is quickest done by entering a small cardiac needle 
between the second and third rib on the right side of the 
sternum bone, staying also on the right side of the back bone, 


28 


along the groove of which the superior Vena Cava lies. 
Rupturing this will relieve the blood, as the Carotid arteries 
are mostly used for the direct injection of fluid into the 
head in posted cases, and those where the general or systemic 
circulation is ruptured. The Vena Cava can be punctured 
and blood drained in all such cases where the vein tube would 
not relieve the blood, nor prevent its forming in the cavity 
at the place of rupture. In all cases where the venous circu¬ 
lation is not ruptured, a safer and more scientific method is 
to remove the excess of blood by means of a draining tube 
inserted in the Jugular or Axillary vein. 

When aspirating the blood, do not produce too much suc¬ 
tion, as excessive suction would draw the tissue, or sub¬ 
stance of the lungs into the perforations of the trocar, stop¬ 
ping them up. To keep it open, it may be pressed gently up 
or down or side to side, thus changing its location in the 
cavity !/2 inch or more, allowing the blood to accumulate 
in the cavity thus made around the needle, which will admit 
of its being easily drained out bv aspirating into the 

bottle. It may be desirable to use this method of drawing 
the blood while injecting any of the arteries, and in cases 
where there is an excess of blood this operation may be 
started any time after one-half or two-thirds quantity of 
the fluid is injected into the artery. 

It is well to always establish circulation before starting to 
draw the blood in this way, because, unlike the vein, it is im¬ 
possible to tie up the puncture in the Vena Cava or right 
auricle of the heart caused by this rupture. This is of little 
consequence, however, after the circulaton is established, 
and thereafter will only drain into the cavities surrounding, 
and not cause any annoyance through leakage from the sur¬ 
face of the incision, or if it does, it may be easily stopped 
by plugging a little cotton or sewing the incision. 


29 


I might add just one more word of advice to the operator 
who is so unfortunate as to rupture a vein while raising 
this artery for injection. In that event, there is a constant 

leaking of blood, which grows worse as the fluid is injected 
into the arteries. Sometimes this may be prevented 

by using a self-closing forceps, or vein clamp, but if it occurs 
deep in the incision, and is unhandy to get at, tap the 
superior Vena Cava, or right auricle of the heart, drain the 
veins to the point of the rupture of the needle, so there is not 
the quantity of leakage at the point of the incision at the ar¬ 
tery. This is worthy of your special note, particularly in the 
event that you are operating before critics. A rupture of this 
kind occurring would prevent you otherwise from doing a 
clean and neat operation. 

After the injection and the removal of the nozzles, wash 
out the wound with a soft moist sponge. Pack absorb¬ 
ent cotton in snugly, sew up the wound with close stitches 
over and under (as a baseball cover is sewed), and draw 
each stitch tight. Silk should be used for this purpose. 

HOW TO LOCATE, raise: AND INJEXT THE} BRACHIAL ARTERY. 

The Brachial artery is used perhaps more than any other 
artery in the body for the present day embalming, and with 
the Axillary artery it perhaps is entitled to this popularity, 
particularly with those operators who prefer to use one of 
the various kinds of vein tubes for removing blood from the 
venous system. 

In large, well developed, and old people, it matters little 
whether the Brachial or Axillary is used, each being large 
enough; also the accompanying vein (basilic) is large enough 
to receive at least a medium-sized vein tube, but in young and 
less developed people it is advisable to raise the artery high in 
the arm, indeed at the bend of the shoulder, where the Axil¬ 
lary is found, because there both the artery and vein are con- 


30 


siderably larger than in the middle third of the arm, where 
the Brachial is usually raised. 

The Brachial artery (B, plate 4, Upper Extremity) is the 
continuation of the Axillary artery, and commences at the 
entrance into the arm from the axilla, or arm-pit. It con¬ 
tinues, in a more or less spiral course, to the bend of the 
elbow, where it gives off two branches, which are called the 
Radial and Ulnar arteries. If the arm is directed outward 
in a straight line from the body, with the palmar surface of 
the hand towards the feet, the artery pursues an almost 
straight course. For this reason it is advisable to extend the 
arm outward before making an incision, then you can make 
the incision in a straight course, and with exactness. 

The artery lies near the Humerus (tlie bone of the arm), 
and between the two great muscles, the biceps and triceps, 
on the inner side of the arm, the biceps being on the upper 
side, forming, as it were, an overshoot, and the triceps on 
the lower side of the artery. It lies along their edges or 
interior borders, closer to the biceps, and is hidden from view 
until the muscles are separated. That work is accomplished 
easily by the use of the bone separator and aneurism hook. 

Make the incision about two or three inches below the 
arm-pit and in the middle of the arm between the muscles. 
Make it from one to two inches in length. Cut through the 
skin and fascia on a straight line with the bone of the arm. 
Then separate very carefully the fat and muscles, and hold 
the muscles apart, thus exposing to view the sheath contain¬ 
ing the nerve, the Brachial artery, the two Vena Comites, 
cords, etc. 

You are seeking the artery, and may depend upon finding 
it always in the same place. In surgical anatomy the de¬ 
scription is different, because a slip of the knife might sever 
the artery and cause death, therefore the greatest caution is 


3i 


always advised, but in our work, where no danger results 
from such anomaly, we may better direct our efforts accord¬ 
ing to the lineal guides which we have for the artery. 

The Brachial artery is contained in the same sheath which 
surrounds the median nerve and the two accompanying veins 
(venae comites, or Brachial veins). These lay closer to the 
biceps muscles, which in many arms form a little ‘Torbay” 
over them. Push this back with the thumb towards the top 
of the arm. This will expose to view, and to the sense of 
touch, the nerve and artery, which lie immediately beneath. 
Separate this from the other substances, pushing the tissue 
away from it, and pass, the finger of the left hand beneath; 
then, with the freedom of the right hand, the blunt aneurism 
needle may be used to the best advantage in separating the 
nerves, arteries and veins. 

To the practical man this is all accomplished in less time 
than it requires to tell it. In certain abnormal conditions the 
arteries vary, and instead of one artery there may be a bifur¬ 
cation of the Brachial artery into two arteries. Statistics 
show that this occurs about once in every 12 cases. I might 
add, however, that it occurs more frequently in the left 
arm than in the right, and the majority of cases are females. 

When these arteries are divided in two (occasionally in 
three) they are proportionately small, and where such ab¬ 
normal condition exists it frequently occurs that the vein is 
somewhat changed. Even the walls of the veins are thicker, 
therefore less distinguishing features exist in contrast with 
each other, and in consequence the usual signs of determin¬ 
ing the artery are absent. The sense of touch does not dis¬ 
tinguish the artery. The walls of the veins, being thick, do 
not show the color of the blood so plainly through them by 
their transparency, so by the sense of sight we can not so 
well distinguish the artery from the vein. 

o 


32 


Branches of the artery so varying do not point out by 
their construction the difference between the artery and the 
vein, and perhaps it remains for us to use the only certain 
and specific test for the artery, which is the injection of this 
same artery towards its extremity. This at once develops 
capillary circulation, which is a sure sign that it is the artery. 
The veins in the arms have valves which always prevent this 
capillary circulation, usually the fluid will not flow through 
the vein towards the hand—perhaps not more than once out 
of a dozen times—and even when it does it only goes to 
where there is a branch from that vein to another one which 
leads it back towards the body. 

Please make no mistake about this test; it is absolute and 
specific. Injection through the vein towards the extremity 
does not admit of circulation there, but circulation towards 
the body is no test, because it is natural for the blood to flow 
through the veins towards the trunk; therefore as much fluid 
may be injected in the vein as in the artery in this way, and 
of course it would be of no benefit, but probably detrimental 
to the appearance of the body, on account of the flushing of 
the blood from the veins through some valves, particularly in 
the neck, which would admit the blood and fluid passing 
through them. 

After determining which is the artery, by whatever means, 
you find necessary, its separation from the vein, as a rule, is 
easily accomplished. 

The artery should be raised to the surface, and two strings 
passed under it. Then raise the vein, and proceed in the 
same way as for the artery. You can open this vein in the 
arm, using the vein tube, to relieve the discolorations in the 
face, if necessary. This acts very nicely, particularly where 
there is an excess of blood. 

The vein tube can easily be passed into the vein, especially 



























■ 




































/ 










BOTH CAROTID ARTERIES (one incision 1 % inches long.) 









33 


if a cross incision is made half way in the vein, then a little 
cut from that point upwards about *4 inch long. Holding 
the little flaps open with tweezers enables the operator to 
pass the vein tube therein as far as it is necessary to go. 

It is usually supposed that the vein tube should enter as 
far as the right auricle of the heart. There is no objection to 
this, but there is surely no need of it, as the last valve in the 
subclavian vein is at least one inch from where it empties 
into the innominate vein, and therefore does not prevent the 
free flow of blood from the other veins to it (see plate) — 
jugulars on both sides of the neck, and all their branches 
through the innominates or Vena Cava, to the subclavian 
on the other side, so that draining the blood at that point, 
or anywhere in this tract, relieves the veins which drain the 
blood from all of the exposed parts of the body, head, and 
hands, hence admits of a free circulation of the fluid through 
this tissue, washing out the capillaries in a most thorough 
and practical manner, and therefore prevents flushing, and 
with a little careful manipulation of the tissue of the face 
and hands while the injection of fluid is taking place, dis¬ 
tributes it evenly through the face as well as the hands and 
arms, and leaves the clear fluid in the tissue, which produces 
the nicest and clearest complexion, which is so desirable to 
the embalmer. 

As the flexible vein tube is larger than the arterial tube, 
and more cumbersome to handle, it is best to enter it in the 
vein first. After getting it properly placed therein and tied, 
a nipple or cut-off on the vein tube will prevent any annoy¬ 
ance by escaping blood and leave the operator free to enter 
the arterial tube. The work will thus be better done. 

After bringing the artery to the surface, and when the 
strings are placed, tap it bv inserting the point of your scal¬ 
pel into it, the artery being stretched across the handle of an 




34 


instrument. Then insert the nozzle into the opening you 
have made, pointing it toward the body, then make the noz¬ 
zle fast by ligatures already prepared, and inject the em¬ 
balming fluid. 

After injecting a quart or more of fluid, you will find, by 
taking the nipple off the vein tube and attaching a rubber 
tube thereto (allowing this to drain into a bottle), that in 
almost every case a free flow of blood will occur. Allow 
this to continue while you are injecting fluid, and then so 
long as it runs mostly blood; afterwards withdraw the vein 
tube and tie up this end of vein, the other end, of course, 
having been tied up at the time you entered the vein tube, 
and continue injecting fluid in the artery until sufficient fluid 
is used to satisfy you of perfect circulation. 

The amount of fluid varies in each case just as the blood 
of each case varies, as well as the age, and there is also a 
still further difference of conditions warranting greater or 
less fluid used. The sooner a body is embalmed after death, 
the greater caution is necessary not to use too much fluid, 
while if a body remains from four to ten hours after death 
before it is injected, scarcely any danger of “appearance of 
over-embalming” will occur, and therefore a greater quan¬ 
tity of fluid may be used, which often gives the greatest satis¬ 
faction to the operator. 

When you have completed the injection according to your 
own judgment, withdraw the nozzle, ligate the artery and 
sew up the incision. 

HOW TO LOCATE, RAISE AND INJECT THE FEMORAL ARTERY. 

The Femoral artery, on account of its size, and as it is the 
principal trunk artery of the lower limbs, is used by em- 
balmers with the Iliac artery with more or less frequency, 
and whatever is said of one applies to the other. 


35 


The Profunda is a branch lying directly alongside of it, 
and is frequently mistaken for the Femoral. There is but 
little difference between them, and while injecting towards 
the body it does not matter whether one or the other is used. 
Injecting towards the foot, however, it is very important 
that the Femoral artery, which lies closer to the surface, be 
used, because it alone extends to the knee, and there on to 
its branches, conveying both blood in life and fluid after 
death to all of the flesh tissue in the extremities of the leg, 
and as this Femoral artery is used mostly for direct circula¬ 
tion in the leg, it is important, indeed, that this be the chosen 
artery, because it is used principally for the sole injection 
of the thigh and leg. 

It is advisable to raise this artery as high in the limb as it 
is possible for the operator to do, and therefore I would ad¬ 
vise the use of the external Iliac artery. 

The Femoral artery is the continuation of the external 
Iliac artery (F, back plate Body), and enters the thigh from 
its continuation after passing over the crest of the Ilium (39, 
back plate Body), and under Poupart’s ligament (31, Mus¬ 
cle Plate). Immediately upon its entrance into the thigh it 
becomes the Femoral artery. It pursues a spiral course, and 
continues down to the lower third of the thigh, when it be¬ 
comes the Popliteal artery (H, plate 5, Lower Extremity). 

The Iliac lies closer to the surface than does the Femoral, 
because it comes up over the Ilium bone, under Pou¬ 
part’s ligament, and at this region lies just half way be¬ 
tween the Pubic bone in the front and the head of the Femur 
bone. An incision through the superficial fascia 1 or 1 y 2 
inches is sufficient, and with the use of the blunt aneurism 
needle it may be easily found and brought to the surface. 

Injecting downwards into this artery fills all of the 
branches of the external Iliac and Femoral arteries. The 


36 


upper ones supply the entire thigh, and, indeed, curve up¬ 
wards, extending around over the lower part of the abdo¬ 
men, and therefore are of great importance, in injecting the 
extreme parts on a body, particularly one that has been 
posted. A trial of this will show how complete this circula¬ 
tion is, particularly on bad cases, where the green color of 
decomposition has been marked throughout the abdomen. 
Just below that point the Femoral artery begins, and about 
1F2 inches below Poupart’s ligament it gives off a branch 
almost as large as itself, which supplies the tissues in the 
thigh and circulates through its many branches. 

The Femoral artery can be located about the middle of 
the thigh and between its great muscles, about two inches 
below Poupart’s ligament. In making your incision, there¬ 
fore, you mark out your course from about two inches be¬ 
low the center of Poupart’s ligament, near the middle of the 
thigh, and dissect perhaps an inch or an inch and a half 
down through the soft tissues that you come in contact with. 

Divide and cut until you come to the large muscles of the 
thigh, then separate and place them on either side, after 
which you will discover the Femoral and Profunda lying 
side by side, accompanied by the Femoral vein, the venae 
comites, two in number, and the great nerves of the lower 
extremities. Your greatest difficulty will lie in separating 
these one from another, but care will accomplish it. 

After separating the Femoral from the Profunda you can 
raise either one to the surface and pass your ligatures around 
it, as explained in the case of the Brachial artery, one on 
each end, and allow them to hang loose until you need them. 

If it seems wise to tap the vein in this instance, it can be 
done, as in the Basilic or Axillary veins, first, however, 
having raised the vein to the surface and having, the vein 
tube properly placed. 


37 


Attach the tubing to the nozzle that is placed in the canal 
of the artery, inject slowly at first, but with a quicker mo¬ 
tion as you proceed, though never hurriedly. 

This description for the injection of the Femoral artery 
with the use of the vein tube is intended, of course, for the 
injection of the body when no post-mortem has taken place, 
and when the injection is being made towards the trunk of 
the body. The vein tube is only used here when it is not 
used elsewhere, and when the case warrants the withdrawal 
of blood. 

There is some discussion about the withdrawal of blood, 
as to when it is necessary, etc. ’ One's own good common 
sense and judgment has to dictate this. There are certainly 
some cases where no blood need be relieved, because sufficient 
fluids may be injected in the arteries to preserve the body 
indefinitely, and there is not sufficient blood in the vascular 
system to retard the circulation of the fluid or to discolor 
any of the exposed parts, the face and hands; but in cases 
of sudden death, of well developed people, the blood, in some 
cases, occupies so much space in the systemic circulation that 
it does not admit of a free, thorough circulation of the fluid, 
particularly through the capillaries at the extremities of the 
body. 

Pressure on the arteries is not so great at the extremities 
as it is near the point of injection, or at the center of the 
body, the beginning of the circulation, and particularly is 
this so where the valves of the veins, as in the neck, do not 
prevent regurgitation of the blood through them (backing 
up of the blood from the veins to the tissue.) When the 
circulation of the fluid through the tissue for disinfection is 
prevented, allowing the blood and fluid to remain in the tis¬ 
sue, thus producing first a flushed appearance (and the 
longer the body remains the darker and more unnatural this 


3§ 


makes the complexion), in such cases it is well for us to 
realize that it is contrary to nature for “two things to occupy 
a single place,” and it is desirable to have in the tissue of 
the face, as well as elsewhere, clean, clear fluid that produces 
no color whatever, instead of blood, or even a mixture of 
blood and fluid. Therefore, in all such cases it is wise to 
allow the blood to drain from the body, which will prevent 
the flushed condition described. 

HOW TO LOCATE, RAISE AND INJECT THE POSTERIOR TIBIAL 

artery. 

The Posterior Tibial artery is very seldom used. This 
artery (lower part of plate 5, Lower Ext.) is a continuation 
of the Popliteal (plate 5, Upper Ext.) and descends on the 
inside of the Tibia bone. At its beginning it is quite deeply 
seated, but becomes superficial as it descends toward the in¬ 
ternal ankle. It then passes into the foot and ravels its in¬ 
ternal edge, crosses over under the sole of the foot, and 
communicates with the Plantar artery and the Internal Tib¬ 
ial artery. 

At the point of incision, the Posterior, while superficial 
is quite small, and yet is frequently as large as the Radial 
in the arm. The incision must be made about two inches 
above the internal ankle, and about one inch below it in a 
direct line. 

The point of incision should be midway between the in¬ 
ternal ankle and the tendon of Achilles (No. 19, plate show¬ 
ing points of injection), which is the large tendon running 
up from the back part of the heel to the large muscle at the 
back of the leg. 

The location is plain, and the injection easy. The Artery 
is readily reached by dissecting down. It is available for 
use in most cases. This artery is treated just as are the 



. • 































■ 
















































SPIRAL, VEIN TUBE. 













39 


others. Tonit the nozzle upward toward the body, injecting 
very slowly at first. 

At the completion proceed as ordinarily. Never use this 
artery in severe cases. 

HOW TO LOCATE), RAISE) AND INJECT THE) RADIAL ARTE)RY. 

The Radial artery is seldom used, on account of its small 
size and distance from the heart. Other points are far su¬ 
perior to it in this respect, so that it has lost nearly all of 
the popularity it once had. 

This artery (B, plate 4, Upper Extremity) is a branch of 
the Brachial (A, plate 4, Upper Extremity), and begins its 
course at about the elbow joint, and extends along the fore¬ 
arm to the wrist, where it runs into the hand and anasto¬ 
moses with its arteries. 

It is by this artery that physicians feel the pulse at the 
wrist. By means of its being very near the surface at this 
point, its course can be readily located and traced. 

For the purpose of embalming it can be raised just at the 
beginning of the wrist and at the end an inch or so up to¬ 
wards the elbow. 

It can be easily located in the hand or wrist by holding 
the hand with the palmar surface upward, and feeling along 
the wrist on a line with the thumb, outside of the tendon. 

Having located its track, make your incision through the 
skin and separate the fascia with a dull or blunt instrument. 

Raise the artery, pass your ligatures under it, leave them 
hanging loose, tap it with the point of your scalpel, and in¬ 
troduce your nozzle into the canal. Ligate the nozzle, and 
be sure the ligation is firm, as the radial artery is small, and 
will not bear the passage of much fluid through it at one 
time. For this reason there will be a strain on the pump and 


40 


nozzle all the time you are at work. Still, with care, a body 
can be enbalmed through the Radial artery. 

After your injection has been completed, proceed in the 
same manner as with other arteries, except that more care 
and attention must be paid to the closing of the wound at the 
wrist, as it is imporant to hide all evidences of your work. 
The neatest and best way is by means of a very fine needle 
with fine sewing silk to sew up the wound, using great care, 
taking very small stitches, and drawing the lips of the wound 
firmy together. Never allow them to overlap each other. 
When your sutures are finished, place a very small piece of 
flesh-colored court plaster over them, and sprinkle flesh pow¬ 
der over the whole surface, making the part look as much 
like the rest of the arm as possible. 

GENERAL DIRECTIONS FOR ARTERIAL EM¬ 
BALMING. 

It is desirable to have a body on an embalming board, 
or couch, as it is more convenient to get around, and also 
because the proper elevation can be given to the body. It 
is surely desirable to take advantage of the laws of gravita¬ 
tion, to drain the blood away from the head and face by 
elevating the shoulders and the head, so that at least all of 
that part of the face which is exposed, to the back of the 
ears, is at a higher elevation than any other part of the body. 

There is no fear of fluid running away from the tissue 
after it is once circulated. The capillaries through or into 
which the fluid must get to disinfect the flesh tissue are so 
small that it would be an impossibility for the fluid to run 
out again through the arteries, and if it passes on through 
the veins it has so thoroughly disinfected the flesh tissue 
that no decomposition can occur. 

After a body is thoroughly embalmed, it is important that 


4i 


the cavities as well as the mucous membranes of the nose, 
mouth, and eyes be cleansed and disinfected. A little 
cotton moistened with fluid, held with a pair of for¬ 
ceps, should be used beneath the eyelids. Injection of fluid 
through the nasal tube should be made in the mouth and 
nose, and enough fluid injected therein to fill the trachea and 
bronchial tubes. After they are filled, the Adam's apple may 
be manipulated so as to admit of fluid going therein, and if 
the body has a cadaveric odor, which is very often the case, 
this may be easily and nicely taken care of by bathing it in 
fluid. Disinfecting both the inside by arterial injection and 
the outside by washing, will produce sanitary conditions de¬ 
sirable in all cases. 

SPECIAL TREATMENT FOR DIFFICULT CASES. 

Under this subject there are constantly new and better 
ideas and methods advanced. In ordinary cases general an¬ 
atomy guides the operator to usual success, while each and 
every stage permits some new or different action or method 
in the bad cases. To get the best results one needs not only 
good judgment, but experience as well. 

One thing which should always be remembered is that it 
is necessary not only to have the proper application, but to 
have a fluid which is a disinfectant, which destroys the 
germs of decay as well as changing the albumen of the tis¬ 
sue as food for embryonic bacteria to develop on, which con¬ 
tinues the degeneration of the substance. When you know 
you have this kind of fluid, your first and universal efforts 
should be to get sufficient fluid distributed properly, and in 
sufficient quantity in all cases. The intelligent application 
of fluid in the various cases leads to certain success. 


42 


HOW TO EMBALM A CASE OB CONSUMPTION. 

First conclude from the stage of Consumption whether 
the lungs have been wasted away by the disease, and 
whether pulmonary circulation, as well as the systemic cir¬ 
culation (by the bronchial arteries) is destroyed. If so, then 
it is often the case that in this disease the tissues are so weak 
that but little pressure develops leakage. Then it is best to 
use the Carotid arteries. 

After injecting down towards the body with sufficient 
fluid, inject both the Carotid arteries towards the face. As 
the face is the most important exposed part of the body, it is 
necessary to distribute enough fluid there to preserve it un¬ 
til the funeral, or for all time. Having this done, the em- 
balmer feels sure that the part which he wishes to expose at 
the funeral will be perfect. The injection towards the body 
is sufficient to be made through one artery alone. These 
arteries enter the aorta close to each other, and it would be 
useless to divide the quantity of fluid and inject it through 
both of them, as through either one it would reach the same 
parts of the body. 

In the event that purging is produced from the lungs, 
through the trachea, before sufficient fluid is injected in the 
body, care for this purged liquid by absorbing it with cotton 
or a sponge, and when it is excessive place the nasal tube 
on the aspirator and drain from the throat into a bottle, and 
continuing the injection would prove by the distention of the 
superficial veins throughout the body whether circulation 
was had to a sufficient degree to hold the body as long as 
desired. If not, it might be necessary to inject the Brachial 
arteries towards the hands, and the Femoral arteries to¬ 
wards the feet, and hypodermic the body with a medium 
sized perforated needle. This, however, would not be war- 


43 


ranted on the first day, or, indeed, until conditions would 
prompt such heroic treatment. 

It is rare, indeed, when a lesion will admit of sufficient 
leakage in Consumption to prevent the circulation of the fluid 
anywhere except in the face, and your injection through the 
Carotid arteries upwards will relieve any anxiety in this 
respect. 

In Consumption cases there is seldom sufficient blood to 
warrant draining it from the body, and with the exception 

of the thoracic cavity and upper extremities there is little 
likelihood of any trouble, because of the thinness and scar¬ 
city of blood and tissue. 

Care should be exercised, as in many cases of Consump¬ 
tion the lungs have become decayed. Application of the 
fluid needs to be made through the nose into the trachea and 
into the bronchial tubes. The fluid also needs injection 
through the needle in Consumption of the Bowels, Lingering 
Consumption and Hasty Consumption. All these cases re¬ 
quire special care. The contents of these emaciated frames 
is generally a mass of decomposing material, forming gases 
and threatening the whole body with premature decay. 
Such cases are desperate ones, and require prompt and he¬ 
roic treatment. 

The Carotid artery is preferable for this class of work, 
as the fluid is easily forced from it throughout the entire 
system. 

Follow the injection of the artery with the customary 
treatment of the thoracic cavities; perforate the diaphragm 
from the point at the naval as usual, and inject at least a 
quart of fluid into this cavity, or more if you can do so 
without too much distention. Then extract the gases, and 
inject the fluid. 

If properly embalmed, a consumptive body may be pre- 


44 


served for a week or ten days as readily as for two or three 
da vs. 

j 

The embalming process in cases of Consumption improves 
the appearance of the dead. 

Arterial embalming should be employed in all cases; and 
where decomposition has set in, cavity embalming may be 
done in conjunction with it. Whenever the bowels are the 
seat of trouble, such heroic treatment is required. 

In such advanced stages of decomposition, the abdominal 
cavity should be treated with a liberal quantity of fluid, as 
gases form very rapidly. It is more than likely that on 
your arrival at the house you will find the body purging, the 
abdomen very much distended, the subject, in fact, decom¬ 
posing rapidly. Place the body properly on the board at 
high enough elevation so that for the time being purging 
will cease, allowing you to proceed with raising the artery 
and starting its injection. Should it commence to purge, it 
is time to use the trocar to puncture the transverse colon, or 
perhaps the stomach from the abdominal insertion of the 
trocar, aspirating and using all means at your command to 
assist the escape of the gases, after which the purging will 
cease, the body will assume a more normal condition and 
have a free circulation. Embalm through the Carotid artery 
in all such cases. In fact, whenever the subject is in bad 
condition, the greatest safety lies in arterial work. 

A collateral benefit arises from raising an artery in con¬ 
sumptive cases. It is this: that as there is usually only a 
small depth of tissue or fat to penetrate, the artery is easily 
and quickly reached, and a certain familiarity and expert¬ 
ness in the work gained at small expenditure of risk or ef¬ 
fort. In such cases practice feeling of, and familiarizing 
yourself with, the artery. It will be good drill for you. 




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45 


HOW TO TREAT A CASE DYING OE PNEUMONIA. 

To embalm in cases of Pneumonia, follow about the same 
methods as in Heart Failure, Asphyxiation and Apoplexy. 
Pneumonia is an inflammation of the tissue of the lung. 
The lungs, therefore, are the seat of the disease, with the 
pulmonary circulation impaired, and as this circulatory sys¬ 
tem influences the systemic or functional circulation of the 
body, the embalmer finds that in a majority of the cases the 
blood has produced a coloration in the face and neck, there¬ 
fore, to best embalm such case use the axillary artery and 
the axillary vein, which will allow the draining of the blood 
before or at the time the arterial injection is begun. 

Pneumonia varies from Consumption in this particular re¬ 
spect; as it is a disease which usually causes death from short 
illness, consequently it is quite natural to find an excess of 
blood which needs to be relieved, therefore, use the new 
axillary vein tube, easily accomplished when using the Axil¬ 
lary artery for injecting the fluid, because at this same in¬ 
cision the vein may be used to enter the vein tube. 

The question might be asked: “Why not use the Jugular 
vein and the Carotid artery?” This would be all right 
in the morgue, or where the body is not surrounded with 
clean clothing or linen, but in a private home, where so 
many of these cases must be treated, the operation of raising 
the Jugular vein is more or less likely to be attended by 
troublesome leakage of blood. On account of its location it 
is very difficult to manage this without leakage, but with the 
vein in the arm, even though it should leak, it is very conven¬ 
ient to have a rubber cloth or apron placed beneath the arm, 
and with cotton or sponge absorb the leakage. 

It is highly important that the blood be considered in the 
injection of Pneumonia cases, because in the congestion of 


46 


the lungs previous to death the blood is darker than in ordi¬ 
nary cases, therefore its presence in the tissue produces the 
worst kind of discoloration. 

Pneumonia cases frequently become flushed from the in¬ 
jection of fluid, and in every case the operator should be 
prepared to drain the blood through a vein tube, or if pre¬ 
ferred use a perforated needle, rupturing the superior Vena 
Cava, entering between the second and third rib on the 
right side of the Sternum bone. If the hollow needle be 
used, it should always be after injecting a certain portion of 
your fluid. Bv injecting first, you establish at least a par¬ 
tial circulation and feel satisfied regarding its preservation, 
and also liquefy the blood so that it will run freely through 
your needle when you start to aspirate it. 

Pleurisy can be treated in the same way, as it is closely 
allied to lung diseases, and oftentimes Pneumonia develops 
Pleurisy. In such cases there is a Pleuro-Pneumonia, which 
may be treated in the same manner. 

To embalm a body dead from either Heart Disease, Alco¬ 
holism, Paralysis, Poisoning, Sunstroke, Heiat Cases, or 
Sudden Death Cases, and whenever blood is excessive, pro¬ 
ceed by injecting through the Axillary arterial tube, drain¬ 
ing the blood from the Axillary vein, as in Pneumonia 
cases. 

sunstroke, or heat-cases. 

Here a peculiar condition exists, usually in heat cases. 
The temperature rises previous to death to a higher degree 
than in any other cause of death. It is not infrequent to 
find the temperature no degrees, and after death the tem¬ 
perature is likely to increase a few degrees, and special cau¬ 
tion should be observed because the embalmer realizes that 
“heat and moisture’’ are the two principal elements that 
hasten decomposition. 




47 


With the excesive heat, decomposition is likely to proceed 
very rapidly, especially when the circulation is also some¬ 
what interfered with by the congestion of the blood in the 
tissue. It is a safe plan to use at least twice as much fluid 
on these cases as ordinary ones, and continue the injection 
and manipulation all over the body with a wet sponge so as 
to stimulate the free circulation of the fluid in the capil¬ 
laries. The injection of a large quantity of fluid makes it 
necessary to relieve the veins of the blood which they 
usually contain in great abundance, and it is best to drain 
the blood from the veins. Use a trocar to draw from the 
Vena Cava, if you prefer this method. 

There also may be conditions to treat afterwards, where 
circulation has not occurred, and when decomposition sets 
in. This may be readily taken care of by the injection of 
fluid in the arteries again, or perhaps by hypodermic injec¬ 
tion with the proper sized needle, according to the amount 
of surface to be treated. 

It may be advisable in such cases to embalm in the Car¬ 
otid arteries, injecting both of them upwards (after inject¬ 
ing the one down), as by this application a sufficient quan¬ 
tity of fluid is distributed through the face tissue to pre¬ 
serve it for all time, thus obviating the necessity of any 
later treatment of it. 

Cavity injection is also necessary in such cases, on ac¬ 
count of there being an abundance of vegetable substance 
(food) in the stomach and intestines, which is apt to fer¬ 
ment; indeed, it is likely to start fermentation while the 
high temperature yet remains in the body. 


4 8 


HOW TO EMBALM A BODY DEAD EROM TYPHOID FEVER, AND 

LOW TYPE FEVERS. 

While on our guard at all times, in low type levers we 
should be especially so, as they are difficult cases to handle. 
Heroic treatment from the beginning is required. 

Disinfect the exterior of the body, the body clothing, and 
also the bed clothing. 

A body dead from Typhoid Fever generally emits a dis¬ 
charge from the anus, which should be immediately disin¬ 
fected, as it is in this that the deadly contagion lurks. Re¬ 
move at once, and pack something in the anus. 

Cotton saturated with a disinfectant, and forced into the 
rectum through the anus, is a practicable method of pre¬ 
venting disagreeable discharges. But, if that does not suf¬ 
fice, ligate the anus. First having drawn it out with your 
sharp-pointed embalming hook, pass a string around it and 
tie it in double hard knots. You will not be troubled fur¬ 
ther from this source. 

Wash and inject the body, as in any other contagious 
and infectious case. When embalming Typhoid Fever 
cases, it is best to use the Axillary arterial tube for inject¬ 
ing the fluid as a more even circulation is thus obtained. 
Frequently it is of great advantage to the good appearance 
of the body to drain the blood. It is best to use the Axillary 
vein tube for this purpose, or else wait to draw the blood 
until the body has been partially embalmed arterially, when 
you may insert a cardiac needle between the second and 
third rib, rupturing the Vena Cava and draining the blood 
in that manner from the body. Disinfect the blood thus 
drained by using one-third part full-strength fluid. 

The New Transportation Rules require the cavity injec¬ 
tion of Typhoid Fever cases. As the seat of disease is in 


49 


the small intestines, a thorough injection of the abdominal 
cavity is necessary. 

In Typhoid Fever cases, the principal substance most 
infectious is the stool, or discharge from the rectum. 
Therefore, be sure to use precaution. Thoroughly disin¬ 
fect this fecal matter as described for disinfecting the 
blood. Follow this method in all low type fevers, as they 
vary little. 

HOW TO TREAT A CASE DYING FROM A HEMORRHAGE. 

To embalm the body of a person who has died from a 
hemorrhage of the lungs, involves the same treatment as in 
consumptive cases. The body is more easily preserved, 
however. 

You are not compelled to withdraw the blood, as this has 
drained from the tissues during the hemorrhage. Simple, 
ordinary methods answer all purposes, substantial treatment 
of the cavities being all that is really necessary. 

But in cases of Internal Hemorrhage, you have to apply 
all the means at your command, for the blood has escaped 
into the cavities of the body, and prompt and heroic treat¬ 
ment is needed. 

Thoroughly inject the arteries in such manner as to in¬ 
sure its even distribution throughout the body, particularly 
the extremities of the exposed portions. 

Death from hemorrhage indicates ruptured arterial or 
venous circulation sufficient to occasionally necessitate the 
injection of the arteries towards the extremities, the same 
as of an autopsied case. Aspirate the blood and water 
from the cavities where it has collected, and inject fluid into 
these cavities to thoroughly disinfect their contents. 


50 


TO EMBALM A BODY DEAD FROM DROPSY. 

Arterial injection is always necessary to properly em¬ 
balm dropsical bodies, as they cause the embalmer the great¬ 
est anxiety. 

Edema, cellular dropsy, is the kind of dropsy which most 
attracts the embalmer’s attention. Dropsical water in the 
tissues of the lower limbs and also of the upper extremities 
causes their distension to so great an extent, that it is diffi¬ 
cult to secure free and even distribution of fluid through 
these parts by the ordinary process of arterial embalming, 
therefore preparation should be made at once for the drain¬ 
ing of this liquid from the body during the time of the 
arterial injection of the fluid and for the embalming of 
such cases the axillary artery and vein are found to be 
most satisfactory. During the injection of the embalming 
fluid, and while the blood is allowed to drain trom the 
body through the vein tube, the position of the body will 
aid the embalmer much in his successful operation by ele¬ 
vating the limbs, the natural law of gravitation will carry 
all liquid secretions which are forced by manipulation and 
pressure, with the hands, or with rubber bandages, which 
forces this material from the tissues into the veins and 
drains through these veins into the vena cava, from whence 
it may be drained out through the axillary vein tube. As 
a considerable quantity of this liquid secretion drains 
through the lymphatic circulation and through the thoracic 
duct, which empties at once into the subclavian veins. The 
great advantages of the selection of the axillary vein to 
secure the best results are at once apparent. It is always 
an advantage to drain as much water as possible from the 
body either before or during the injection of fluid therein, 
because if this water is allowed to remain in the body, it 


5i 


will dilute the embalming fluid in exact proportion in which 
it exists therein. 

It is true it is difficult to remove, indeed impossible, to 
drain all of the dropsical water from the body, neverthe¬ 
less, a goodly portion may be drained from the surface tis¬ 
sue; this gives place for the fluid to circulate the more 
freely through the extreme branches of the arteries to the 
capillaries, throughout the surface tissue, so that preserva¬ 
tion may be assured and skin slip and dropsical blisters 
prevented. Dropsical water contains sithate of ammonia, a 
slightly alkaline substance, which causes fermentation and 
putrefaction, which to some extent destroys the lesions 
which hold the skin to the superficial fascia, therefore it is 
of the greatest value to accomplish thorough circulation of 
fluid through this substance, to prevent the annoying con¬ 
ditions which usually prevail about the dropsical body. 

In dropsical cases, formaldehyde is to the embalmer what 
nitroglycerine is to the miner. Used in proper proportions 

with hydrogen Per Oxide, the tissue becomes firm and dry. 

% 

At one time the idea was advanced that ammonia neutral¬ 
ized formaldehyde, and that in consequence, formaldehyde 
was not a suitable substance to use in embalming this class 
of cases. Further experiments, however, proved that for¬ 
maldehyde was an ideal chemical to be contained in em¬ 
balming fluids and that ammonia was not a very energetic 
reagent and did not interfere with its efficiency. 

When applying bandages on the limbs, start wrapping 
them at the feet and continue to the thigh. These bandages 
should be left on at least fifteen minutes with the limb 
elevated, so that the dropsical water and secretions may 
drain from the tissue, through the capillaries and into the 
veins which empty into the vena cava and from there may 
be drained in the usual method through the axillary vein 


tube. The rubber bandages should never be allowed to re¬ 
main on the limbs while injecting fluid, because this pres¬ 
sure would cause resistance to free circulation of the fluid 
through the branch arteries to their extremities, and through 
the capillaries. 

After draining all of the water possible away from the 
extremities, the embalmer should continue the injection of 
the fluid until all of the signs are produced to prove the 
thorough circulation of the fluid throughout this tissue. 
This is usually accomplished by the single injection through 
the axillary artery, but should there be tardy circulation, 
it is beneficial, especially in the summer time, to raise the 
iliac arteries and inject fluid into them towards the ex¬ 
tremities, as by this means you may be sure to circulate 
fluid by this direct injection in sufficient quantity to pro¬ 
duce the desired conditions. It is also well to consider 
that in all dropsical cases there still remains in the body a 
considerable quantity of dropsical water, even though a 
great amount has been drained from it. This dropsical 
water, which is contained in the tissue, would naturally 
dilute the embalming fluid, therefore it would be proper to 
increase the strength of the formaldehyde solution by 
adding Primerine or formaldehyde; use a pint to each gal¬ 
lon of fluid, to take care of the average dropsical body. By 
so doing the strength of this fluid will be sufficient, even 
though it be diluted with considerable dropsical water, to 
produce the best results. 

In many dropsical cases, the abdominal cavitv contains 
a large quantity of dropsical water and should be drained 

away. Use a hollow needle or cavity drain tube. Insert 
it through the abdominal wall and aspirate all of the liquid 
secretions therefrom. If a great quantity is present, caus¬ 
ing the distension of the abdominal walls, previous to 


53 


or during the arterial injection, this dropsical water may be 
drained from the cavities early in the operation of embalm¬ 
ing to allow more free circulation of the fluid through the 
arteries to the tissue over the trunk of the body. If a 
sharp needle is used, this operation should follow the ar¬ 
terial injection, as there is always the danger of rupturing 
the arterial circulation by a sharp needle, and this would 
be too great risk to take in dropsical bodies. 

The quantity of fluid necessary to properly care for a 
dropsical body depends largely upon the size of the body, 
also on the length of time the embalming after death has 
occurred (more fluid is needed under these circumstances), 
also the probable dilution of the fluid by the amount of 
dropsical water remaining in the body. Sufficient amount 
of fluid must be used to fill the large and small arteries and 
also all of the capillaries, and as the circulation of fluid 
throughout the extremities is somewhat retarded by the 
disease, therefore it is necessary to produce more pressure 
to secure capillary circulation than on many other cases. 
For shipping cases and those bodies which are kept for 
several days in warm, sultry weather, a gallon of good 
strong arterial fluid should be used to every one hundred 
pounds of tissue. The cavities, also, should receive fluid 
in reasonable proportion to the amount of liquid secretion 
drained therefrom. Cloths should be saturated with em¬ 
balming fluid and should be wrapped around the limbs as 
a further precaution against skin slip. 

These are the most exacting of all cases, and require skill 
and perseverance. 

First, elevate the body on the embalming table as high 
as possible without causing it to sit upright, and let the body 
remain in its elevated position a few moments so as to get 
all the water (the dropsical fluid) into the abdominal cavity. 


54 


Take the point of your knife and cut through the skin, 
or use your dropsical trocar instead, the only disadvantage 
attached to that instrument being its sharp point. 

But, if the case is a bad one, the long, blunt perforated 
needle is the best instrument by far, and should always be 
used, because with it there is no fear of rupturing the ar¬ 
teries and spoiling the arterial circulation. Pass it hither 

and thither, anywhere and everywhere, its great length per¬ 
mitting you to penetrate the abdomen from top to bottom 
and from side to side. You will extract the gases at the 
same time that you are extracting the dropsical fluid. 

Attach the tube to the head of the needle, rigging the 
pump on the opposite side. It will require perhaps an hour 
for the removal of the dropsical fluid, the abdomen dimin¬ 
ishing in size as the water leaves its cavities. 

Now raise an artery—the Axillary answers very well, or 
the Carotid. If there should be any discoloration about the 
face, neck, or shoulders, use the Axillary vein tube without 
fail. In fact, while the water is leaving the abdomen, once 
well started, let it attend to itself and look for the artery, 
thus saving time, though the operation will be long and 
tedious at best; yet you should omit nothing. 

Prepare your ligatures around the artery. When the ab¬ 
dominal cavity shows signs of becoming empty of water, 
begin to inject the arteries, still allowing the long needle to 

remain in the cavity. Inject as slowly as possible at first, 

/ 

increasing your speed as you advance. Inject perhaps from 
three to four quarts of fluid into the arteries. Then care for 
the case as in any other case of embalming. Should there 
be no change next day, leave everything alone; but, should 
there be much water in the legs, it is best to wrap them with 
rubber bandages, starting at the foot and proceeding up¬ 
wards as far as the swelling extends, leaving mem this way 


55 


for half an hour, forcing some of the water from the extremi- 
ties, then take off the bandages and rub the legs well while 
you continue to inject fluid. This produces circulation there 
which otherwise would not be obtained. 

In the absence of rubber bandages, linen bandages may be 
used, but taking them off and putting them on several times 
is much better than just once, because just as soon as a little 
compression has benefited, the pressure ceases to exist, and 
they are of no avail. Better than either of these is the pres¬ 
sure that one is able to give with the hands over this entire 
tissue. It not only forces the dropsical water from the tissue, 
which is carried by the veins into the body, but assists and 
assimilates the circulation of the fluid into the tissue. 

It is an advantage, also, where there is dropsical water, to 
. increase the strength of your fluid by Formaldehyde and 
other substances so that it still has its proper strength after 
the dilution which the dropsical water causes. 

By a thorough and proper manipulation, the fluid, if 
strong enough, may be circulated throughout the entire tissue 
so that blisters will not form nor the skin slip. Use plenty 
of fluid. Two or three gallons is not a large quantity for 
arterial and cavity injection, but the amount should be 
gauged according to the condition and size of the body. 

On limbs that have already been opened and are oozing, 
one of the nicest applications is Plaster of Paris. Place a 
towel beneath each limb. Four or five pounds of Plaster of 
Paris spread over this towel and carefully placed around 
each limb absorbs the moisture, dries, and hardens, and as it 
is an antiseptic, being a preparation of lime, it produces 
the most sanitary and hygienic conditions. 


56 


TO EMBALM A BODY DEAD FROM CHILDBIRTH. 

These are difficult subjects to handle. Ordinarily you will 
need an able female assistant, as there is much delicate work 
to be done. Immediate- attention is required. The arteries 
should always be used. On no account trust to cavity work 
alone. Should there be dislocation, remove it by tapping 
the vein accompanying the artery. 

Care should be exercised that there be no leakage from the 
uterus (womb). If there should be, require your female as¬ 
sistant to fill with cotton and close as tight as possible, and 
bandage with a napkin. Should the leakage continue stub¬ 
bornly, use your aspirator to drain from the pelvic cavity into 
a bottle. 

Continue the injection into the arteries; you will 'find 
the fluid leakage will not equal the amount injected, there¬ 
fore showing that a part of the fluid that you are injecting 
in the arteries is going to the flesh tissue, hence you have 
encouragement to‘continue until sufficient fluid is used to em¬ 
balm the body thoroughly. 

Examination will show whether you have enough fluid 
in the face, and if you have not, inject the Carotid arteries on 
both sides, and if afterwards you find that there are some 
parts that still need an injection (indicated by decomposi¬ 
tion), it will not be the face, for the Carotid artery injection 
towards the face always preserves it, so no fear for the ex¬ 
posed parts need be entertained. Such soft and degenerat¬ 
ing tissue appearing upon the trunk of the body, particular¬ 
ly over the abdomen, may be treated bv a hypodermic injec¬ 
tion of fluid therein. 

After this, proceed with the abdominal cavity, where you 
must be very particular, and equally so with the upper por¬ 
tion, as both are involved in the disease. The. upper in- 


57 


eludes the breasts, which are full of glands and veins con¬ 
taining milk, which requires immediate attention, as the 
gases will form very rapidly. 

Always elevate the head above the level of any other por¬ 
tion of the body, and keep it in that position until ready to 
be placed in the casket. 

In case the child remains in the womb after the death of 
the mother, it need not be removed, because a good cavity 
injection in this region will preserve it. This is necessary, 
as you should not depend on foetal circulation. It does not 
exist in the passive condition of morbid anatomy. 

TO EMBALM A CASE OF PERITONITIS. 

In cases of this nature, use either one of the most import¬ 
ant arteries, and proceed as directed in childbirth cases. It is 
best to drain the blood, therefore the Axillary Artery is 
preferable to thoroughly embalm the tissues of the body. 

As the seat of this disease is the bowels or intestines, with¬ 
out doubt they will be badly distended with gases and need 
immediate attention, as the skin is becoming discolored, and 
it will readily appear that decomposition has set in and muse 
at once be arrested. 

Aspirate the gases and secretions from the abdominal and 
pelvic cavities. 

These gases are in some instances extremely poisonous, 
and always disagreeable, therefore neutralize them at once, 
by having some fluid in the aspirating bottle. Disinfect the 
secretions; it is best to convey the gases out of the room 
by using a ten foot piece of small lightweight rubber hose at¬ 
tached to the injector nozzle of the aspirating pump, with the 
other end of the hose placed outside the window. This 
method of disposing of the gases is to be desired in all cases, 
particularly when the corpse is in a room in which there are 


58 


curtains or draperies and upholstered furniture, which ab¬ 
sorbs and retains bad odors, also any infection or contamin¬ 
ation from any of the communicable diseases. 

These gases, aspirated from the body into the room, al¬ 
ways produce a bad odor, and while the embalmer soon be¬ 
comes enured to it, and even forgets, its presence is very 
objectionable to any of the relatives of the deceased who are 
frequently invited by the embalmer to inspect the body before 
taking his departure, under such circumstances. The first 
impression received by one entering the room is of the bad 
odor produced by carelessness of the embalmer, whereas, had 
these gases been conveyed out of the room, a pleasant odor of 
the fluid or of some perfumed disinfectant would have cre¬ 
ated at once a first and lasting favorable, impression of the 
embalming and of the undertaker’s great care or considera¬ 
tion. 

Inject all the fluid possible into these cavities. 

It may be necessary to extract the fluid on the following 
day and replace it with a fresh supply. Never trust to cavity 
work alone in bad cases, no matter what the cause of death 
may have been, even though the body is to be interred the 
following day. Always do arterial embalming in these cases. 

HOW TO EMBALM A BODY DEAD FROM GUN-SHOT WOUNDS. 

Locate the wound and probe for the ball if it has not been 
already extracted. 

Ascertain whether there has been much hemorrhage, and 
also if any of the arteries have been severed. You will know 
what course the arteries take by a reference to the plates of 
the Aid. 

Ascertain also if any of the viscera, and what part, have 
been penetrated. 



















59 


Inject fluid into the wound, and let it run out, or, if it re¬ 
mains in the wound, you will know that the bullet has entered 
and lodged in one of the cavities of the body and left a canal 
to its bed. Then place a wad of cotton in the wound and 
take a stitch or two in the opening,, thus closing it and im¬ 
prisoning the fluid you have injected. 

If the ball has entered the head, use the Carotid artery 
(19, Head section, Aid). 

By injecting downwards through the Carotid, you take 
care of the body just the same as in any other case, but dv 
injecting upwards you have the opportunity of watching the 
fluid and injecting as fast as necessary. 

You always get more in than will run out of the wound, 
therefore the excess of the fluid is going to the flesh tissue of 
the face, and when any is leaking out, it is going from the 
ruptured arteries in the tract of the wound. You need to 
always watch carefully, however, that you do not distend the 
face and swell the eyes. 

It is not likely that sufficient fluid will run from the wound 
to leak more than a bulbful or two at most, and therefore an 
excess of fluid may be easily had in the face. 

Embalm the body as you would in any other case, and fol¬ 
low the directions given for embalming through the Carotid 
artery. These are not always difficult cases, as hemorrhage 
may save time that otherwise you would have to expend in 
aspirating the blood. 

TO E)MBALM A BODY DE)AD FROM DROWNING. 

First empty the body of the water that has passed into it 
during its period of immersion. 

In cases of drowning, the blood remains fluid, and decom¬ 
position begins at the head and works its way downward. 


6 o 


Force all the water out of the body, then proceed as in any 
case of arterial embalming, providing there are no indica¬ 
tions of capillary gases or decomposition. 

Very often drowning cases are really cases where death 
has been caused from shock, when little or no difficulty wil 
be found in preservation; but where the body, after lying 
in the water for some time, has come to the surface because 
decomposition has set in, producing capillary gases which 
make the bulk of the body lighter than its equal bulk of 
water, then the embalmer should know that he has indeed 
a task before him. 

Wherever capillary gases exist in the tissue, there it is dif¬ 
ficult to get circulation, and indeed it is almost impossible to 
do so, all over the body, by general circulation. 

In such cases it is best to use both Carotids to the head, 
using constant manipulation to stimulate its circulation 
throughout the tissue of the face, and by the same means 
force the gases away from it, and it may be well to rupture 
the Jugular veins. You are warranted in taking heroic meas¬ 
ures under these circumstances. 

In treating the other extremities, it is necessary to use the 
Brachial or Axillary arteries, to inject towards the hand, 
and it may also be necessary to use either the Iliac or Fem¬ 
oral arteries to inject towards the feet, and also to use a 
sharp perforated needle as a hypodermic all over the Trunk 
of the body. 

It is always well to inject one of the Carotid arteries down 
towards the body, and use two or three times as much fluid 
on such cases as in ordinary cases. 

Some of the worst swelled bodies may be treated in this 
way, and in two or three days brought back to a normal state 
of preservation, almost wholly reduced in size from the swell¬ 
ing and with the odor entirely relieved. 


6i 


\\ here the skin has been peeled off the face or hands in 
such preserved body, it may be tinted and the discolorations 
covered, and if laid under the light properly maybe present¬ 
able and altogether satisfactory to the family. 

Puncture the stomach and bowels in the lower cavities, 
and the pleura in the upper, then inject with perfect free¬ 
dom. Cover with saturated muslin, as usual, and place the 
body in its casket. 


APOPLEXY CASES. 

A thorough knowledge of the systemic circulation leads 
to the natural conclusion that the short, heavy, apoplectic 
bodies, (and indeed, in all sudden death cases, the blood 
should be drained from the veins while fluid is injected into 
the arterial system. It therefore is most convenient to inject 
the fluid in the axillary artery and drain the blood from the 
axillary vein, as the embalming fluid naturally follows the 
lines of the least resistance until it is checked in yielding at 
the semi-lunar valve, and therefore gradually fills up the 
aorta and all of its branches before it passes from them to 
the sub-branches, into the capillaries and tissue. 

A long axillary arterial tube which will convey fluid di¬ 
rectly into the arch of the aorta will aid the embalmer in 
distributing this fluid through the branches of the aorta more 
evenly. This is a great advantage in apoplexy cases, as clear 
fluid beginning its circulation in the carotid arteries at the 
arch of the aorta will by an even pressure, circulate to the ex¬ 
tremities of these arteries and have greater influence upon 
the circulation of blood from the capillaries than could be ob¬ 
tained by any other method of injection, except perhaps the 
use of the carotid arteries, directly injecting the fluid through 
both of them towards the face. As the axillary artery is 
found in the same incision as the axillary vein, this single 


(32 


incision method has proven the most satisfactory way of em¬ 
balming these cases. Make the incision through the hair 
line over the axillary artery and vein, about two inches in 
length, separate carefully the artery and vein as described 
elsewhere, in the injection of this artery. 

Apoplexy cases should always be arterially embalmed, in¬ 
deed, it is the only safe and sure way of forcing the blood 
from the capillaries. No special precautions in embalming 
apoplexy cases are necessary excepting to properly take care 
of the blood. The only abnormal condition of the vascular 
system is a distension of some of the blood vessels of the 
brain, which are supplied through the branches of the in¬ 
ternal carotid arteries. As these do not interfere with the 
circulation of the blood through the branches of the external 
carotid arteries, thorough circulation in embalming may be 
as easily done in apoplexy as in any other cases. The blood 
should be allowed to drain from the vein tube at the same 
time that fluid is injected into the artery. A quart of em¬ 
balming fluid should be used to each fifty pounds weight of 
the body, and in addition to this, as much more fluid should 
be injected into the arteries as blood is drained irom ine 
body. During the injection of the fluid, a soft sponge should 
be used over the face, neck and ears to force the blood 
through the capillaries and also stimulate the circulation of 
the fluid throughout this tissue. In the absence of a soft, 
moist sponge use your hands for the massage treatment of 
the tissue. In the first treatment of an apoplexv case, if the 
injection of the axillary artery fails to give the desired re¬ 
sults by the injection of the quantity of fluid you have 
planned to use in the body, and if after you have injected 
through the axillary artery the larger proportion of fluid you 
have along with you and fail to clear the tissue of the blood, 
it then would be advisable to proceed at once with the injec- 


63 


tion of the carotid arteries, rather than to allow any fluid 
which might be contaminated with the blood to remain in 
the face tissues, because the mixing of the blood and fluid 
together in this tissue would gradually grow darker and the 
longer it remains, the more difficult it is to remove. 

Apoplexy cases may be embalmed as easily and thoroughly 
as any other kind of bodies that require the embalmer’s at- 
tention, the particular feature of the apoplexy case being to 
remove the superabundance of blood which must be drained 
from the veins, so that a free circulation of embalming fluid 
through the arteries and capillaries may be obtained. 

IN CASKS OF DKATH BY STRANGULATION OR FROM A BROKKN 

NKCK, 

the same process should be followed. These subjects are al¬ 
ways discolored in the face and upper parts, but the blood 
remains fluid, and will gravitate toward the superior Vena 
Cava and be readily drained therefrom through the axillary 
vein tube. 

Suffocation, hanging and strangulation can be treated 
alike. 

Sunstroke and Apoplexy are in about the same category. 

Use the same method in all. Remove the blood-coloration 
by injecting through the axillary arterial tube. 

TO KM BALM A BODY WHKRK THK THROAT HAS BKKN CUT. 

If the common Carotid artery has not been severed, raise 
and use it as in any other case. If this artery has been 
severed, take hold of the upper end of the artery with your 
forceps and insert your arterial nozzle and inject therein a 
few bulbfuls, as in any other case, then tie the upper end, 
insert your tube in the lower end, and inject the fluid down¬ 
ward. 


64 


TO EMBALM BODIES DEAD EROM ANY DISEASE WHERE POST¬ 
MORTEM HAS BEEN HELD. 

As a rule, in these cases, the doctors increase the em- 
balmer’s difficulties. In cutting the dead body open, and in 
examining the viscera, a great number of the arteries and 
their branches are severed. Yet the gases will have been 
extracted during the post-mortem examination, and should 
the arteries be in sight, ligate (or tie) the ends, and thus get 
a circulation. But this is a tedious operation, and requires 
skill and patience. 

The easiest method is to raise the Brachial artery (A, 
Upper Extremity plate in Aid) and inject towards the hand. 
This will preserve the arm, clear up the hand, and make it 
wholly satisfactory and preserve it from “skin slip,” or dis¬ 
coloration by decay. Treat both arms the same way, then 
inject down in the external Iliac or Femoral arteries, inject¬ 
ing them both towards the feet. This will take care of that 
region of the body, and most important of all is to raise the 
Carotid arteries and inject them upwards on either side of 
the face with a small quantity of fluid, but sufficient to keep 
the face. Thus you will be taking care of the exposed parts 
of the body just as well as though it had not been posted 
at all. 

The leakage that does occur will be from the veins into 
the trunk of the body. This will be blood and fluid, and it 
will do no harm in that region, except that if it becomes too 
full, you should aspirate. 

The trunk of the body may be preserved by using a per¬ 
forated needle as a hypodermic, and injecting throughout its 
entire tissue. This requires considerable more fluid than 
ordinary injection, perhaps two or three times as much in a 
posted body, but the success to be obtained warrants its use. 


65 

“DISCOLORATION.” 


Post mortem coloration, which is due solely to the pres¬ 
ence of blood in the superficial fascia, is easily removed 
either by elevating the head to allow the natural gravitation 
to drain it away, or when this is aided by gentle manipula¬ 
tion with the fingers, or with a sponge, it presents no serious 
question to the operator except that he recognizes that blood 
is there in excess of the usual case. Injecting such body 
through the arteries forces this blood from the capillaries 
into the veins, and when these veins become filled up, this 
blood should be removed or it will offer a resistance to con¬ 
tinued free circulation through all of the tissue all over the 
body, or else it expands the veins, particularly those in the 
neck, the Jugular veins, which have but two valves, and 
when the vein is stretched beyond permitting these valves to 
meet, then they lose their controlling influence and allow a 
regurgitation of the blood, which is now mixed with some 
fluid, back into the face, which produces flushing, and should 
surely be removed at the earliest possible moment, because re¬ 
maining there produces in this tissue a staining of the walls 
of the capillaries and lymphatics, and presents a color much 
the same as a Post Mortem Stain produces, either by decom¬ 
position or by bruises. Neither hot nor cold water is of 
sufficient value, nor produces good enough results for the 
practical Embalmer of the present day to waste time on. The 
Embalmer who gets his circulation knows that he can wash 
ou,t this tissue either by general circulation, draining the 
blood, or when this flushed condition appears and is allowed 
to remain long enough to congest, it may then be best re¬ 
moved by raising both the Carotid arteries and injecting up 
into each side, manipulating the face while doing so, thus 
getting behind the red blood corpuscle, which is in the 


66 


capillary, with the fluid in the artery, forcing it ahead and 
into the veins, which, if relieved by rupturing with a cardiac 
needle, or by tapping the vein with the use of the vein tube, 
this color may be wholly and thoroughly removed. The use 
of cloths on the face is usually attended with some satisfac¬ 
tion. That custom was originated, however, by Undertakers 
who were not Embalmers. On such cases, where they did 
no embalming, or else just a cavity injection, it produced 
some benefit, more by the natural contraction which moist¬ 
ure causes than by any chemical effect from the liquids used. 

In ordinary cases arterially embalmed, moist cloths on the 
face are superfluous, and if kept too long and too moist on 
the face they cause a peculiar shriveling and shrinkage of 
the skin, just as occurs when a person’s hands are kept in 
water for any length of time, and it should be avoided un¬ 
less it be on the face of a very thin person where the absorp- 
tion of the moisture from the face by the atmosphere would 
shrink and dry it too much. Under such conditions moist¬ 
ure on the face, if the moisture be of such nature as to keep 
the skin nice and fresh, would be an advantage. A mixture 
of Rose Water and Glycerine is a very nice application, or in 
the absence of this a thorough application of an antiseptic 
grease keeps the skin soft and velvety and in excellent condi¬ 
tion. 


.r>. 


PART SECOND. 


Instructions and Methods oe Embalming. 

By Charles A. Genxing. 














PART SECOND. 


Instructions and Methods of Embalming. 

By Charles A. Genung. 

DISINFECTION OF THE DEAD BODY. 

All authorities agree that a thorough disinfection of a dead 
body can be accomplished only by introducing a disinfecting 
embalming fluid until all tissues of the body are thoroughly 
disinfected by the fluid. When such condition is reached 
the only change that can take place with the dead body is the 
change coming with desiccation. To produce this disinfected 
condition of the entire body is the object of thoroughly em¬ 
balming it. I believe it possible to accomplish this condition 
with a body, dead from any cause. Oftentimes the em- 
balmer, to accomplish this end, must devote hours of labor. 
Partial embalming may be done in any length of time, vary¬ 
ing from a few minutes to a number of hours. 

To obtain a thoroughly disinfected body, we must in each 
case disinfect the blood remaining in the body. To do this it 
is necessary in many cases to remove some blood, as in these 
cases the introduction, in any manner, of enough fluid to 
disinfect the blood of the body would distend the venous cir¬ 
culation, containing most of the venous blood, and such a 
distension would be undesirable. It is wise, therefore, to 
be ready in all cases to remove enough blood to prevent any 
such unpleasant distension. 

To allow enough blood to pass out of a trunk vein of the 
body by means of a draining tube inserted into and through 
such trunk vein, until it has been passed beyond all valves 


67 



68 


and has reached the “well of the venous blood which com¬ 
prises the right and left innominate veins, the superior vena 
cava, the right auricle of the heart and the inferior vena 
cava, has been the object of all who have invented or used 
any kind of draining tubes. 

The Genung-Eckels draining tube is offered to the em- 
balmer with the claim that, with it, blood may be removed 
in all cases that could be, by means of any other instrument, 
and that this draining tube is free from all the objectionable 
features of the other draining tubes. 

The claims in favor of the Genung-Eckels draining tubes 
are: 

ist. It will at all times remove more blood in a satis¬ 
factory manner than any other instrument. 

2d. Its insertion and withdrawal are accomplished with 
greater convenience and can be done as cleanly as with any 
other instrument. 

3rd. It will not bind in the vein and need never be buried 
with the body, as often occurs with the spiral draining tube, 
and will always leave the vein as easily and freely as it enters. 

4th. It will not clog as easily, and if it should so clog, it 
may be freed better than any other instrument and without 
removing it from the vein. 

5th. It is more easily kept clean than any other draining 
tube. 

6th. The Genung-Eckels draining tubes are durable. One 
set should last a “life time”. 

This work, “The Eckels-Genung Method and Practical 
Embalmer", as its name implies, is a book describing prac¬ 
tical methods of work that should aid the practicing em¬ 
balmer and undertaker in his daily experiences. 

We desire to call the reader’s attention to Rules one and 
two of this work. Carefully study them until you under- 


69 

stand them thoroughly , as reference will be made to these 
rules throughout the work. 

The axillary vein is the best to use in removing blood, 
and the axillary artery, which is found immediately accom¬ 
panying the vein is the most superficial of the large trunk 
arteries and one of the most satisfactory arteries for the 
embalmer to use. 

After the heart fails to perform its function and death 
occurs, the muscular action of the arteries and capillaries 
continues until a large percentage of the blood contained in 
them during life is passed through the capillaries and enters 
the venous circulation, some blood, by the law of gravitation, 
remaining in the capillaries of the dependent parts of the 
body, causing the post mortem discoloration found in such 
parts of almost every dead body. 

When this discoloration exists, it is proof positive that the 
venous circulation, which is capable of distention, is abnor¬ 
mally distended with the blood of the body that before death 
was contained in the arteries, capillaries, and veins. The 
blood of the body gives embalmers the greatest trouble, as 
it is most susceptible to decomposition and causes post mor¬ 
tem staining and puffing of the tissue; in fact, all the trouble 
experienced by us has been caused bv the blood we left in 
the bodies we have embalmed. This would not have occurred 
had we removed enough blood to give us a life-like color of 
the body, and used fluid enough to disinfect the tissue of 
the entire body, and in addition to this, had disinfected with 
our fluid the blood we had allowed to remain in the body, by 
using enough fluid to permeate thoroughly the capillaries, 
mixing, as it must, with the blood remaining in the capillar¬ 
ies and veins, in this way causing a thorough disinfection of 
both tissue and blood. 

That this has occurred we have just as positive signs to 


70 


guide us as the medical doctor has conclusive symptoms to 
guide him in diagnosing different diseases. 

The signs that should guide us in our work are: 

ist. A dryness of the skin. 

2d. A mottled condition appearing. (This will surely 
appear if we use sufficient embalming fluid containing any 
astringent properties,) When an old line fluid is used, these 
most conclusive signs do not appear, and the embalmer is, 
in consequence, more or less in doubt. 

3d. A firmness of all parts of the body. 

4th. A proper life-like color, produced by liberating 
some of the blood from the body, at all times through a vein, 
preferably the axillary, and a gradual lighter color of the 
blood, proving positively that fluid had passed through the 
capillaries and was escaping (both blood and fluid), through 
the vein. 

I advise using the Genung-Eckels draining tube, inserting 
it into the axillary vein; as this vein is more superficial than 
any other equally large vein, it is always found quite near 
the surface and can be raised without disturbing an artery 
or nerve. 

This vein can always be used for the purpose, and by using 
it, any discoloration of the face, neck and hands (the parts 
of the body, by the way, which are exposed to view on the 
day of the funeral) may be removed that can be removed 
in any other manner. Even in cases where there is a great 
amount of fibrin contained in the blood, enough of the liquid 
or serous part of the blood will filter out through the drain- 
ing tube to give us this result, even though all the fibrin 
does not pass out. There are no valves in the arteries, there¬ 
fore an injection in any one of the arteries will carry fluid 
to all others (in normal cases this will occur). 

The most uniform and equal distribution of fluid is se- 




HOLDING TUG VEIN OPEN WITH VEIN TORCEPS PREPARATORY 

to inserting the genung-eckels draining tube. 












cured when we inject the embalming fluid directly into the 
aorta. This can be accomplished easily by raising the axil¬ 
lary, iliac, or femoral artery, and inserting a flexible silken 
catheter of sufficient length to enter the aorta. By injecting 
the fluid through such catheter, it is started on its way at 
the same point in the systemic circulation, that the blood 
circulation starts from the heart in life, and the circulation 
of the fluid will be as general and complete, as is the blood 
circulation. This should always be done, for the following 
reasons: 

1 st. There is never so quick an escape of the fluid with the 
blood out through the axillary vein if one of these arteries 
is injected in this manner, as there often is in using the 
brachial artery for injection, and the accompanying vein to 
allow blood to pass out. 

2 d. Often when injecting through the radial, brachial, 
axillary, or carotid arteries, using a short artery tube, the 
signs of dryness, firmness, and the mottled condition appear 
first nearest the point we are injecting, and oftentimes spread 
and become so marked as to cause us to stop injecting fluid, 
even though no signs of any fluid having entered the lowei 
limbs or lower part of trunk of body have appeared. To 
continue injecting fluid until they appear on the limbs and 
trunk has often given, and often will give, undesirable¬ 
looking hands, neck or face (usually on one side.) We 
must stop the work of injecting fluid before we produce this 
objectionable result, even though the lower part of the body 
has not been properly disinfected, as we have been, and in 
future will be, called upon to show the hands, neck, and 

face on the day of the funeral. 

By injecting through the axillary, femoral, or iliac artery, 
using the long silken artery tube, such unpleasant results 
will not follow. 


72 


INJECTION BY GRAVITATION. 

I belive in all fluid being injected by gravitation, one to 
four feet elevation being enough to inject in any case of 
arterial embalming, at the rate of one quart in ten minutes. 
Faster than that may cause putty-colored or any other col¬ 
ored spots that are never caused by slow injection. The 
amount of fluid necessary to produce the four signs given 
will vary from one quart to every twenty pounds, to one 
quart to every fifty pounds of the weight of the body, ac¬ 
cording to the condition of the case. A slender body, dead 
a number of days, may need more than one quart to every 
twenty pounds of weight; a fat body, or one injected shortly 
after death, may show all the above signs before one quart 
to even fifty pounds has been injected. 

Having tried all methods of embalming that I have ever 
been instructed in by the bright men who have given their 
talents and time to instruct us and all the methods I have 
read of during the last few years, I have practiced almost 
entirely the work as described, viz.: passing blood out of 
the axillary vein and injecting through the axillary, femor¬ 
al, or iliac artery, and believe it to be the method that gives 
the best* results. 

It seems nature intended us to use this vein, as the axil¬ 
lary region is the only one (I know of) where we come 
upon the vein first. Some men for certain reasons maintain 
that the iliac vein is just as good for drawing the blood. My 
experiences in using it have disproved this to my entire sat¬ 
isfaction, as in many cases, I have had swollen jugular veins, 
with discoloration remaining in hands, face and neck, even 
though blood (or blood and fluid) passed out, producing a 
thoroughly disinfected body, but upon examination of these 


bodies, I have found that large quantities of fibrin had filled 
the entire space of the right auricle of the heart and would 
not allow the blood which caused the discoloration of hands, 
face or neck to pass through and out of the inferior vena 
cava. 

I admit that a like filling of the right auricle of the heart 
with fibrin may occur if blood is drawn from the axillary 
vein, but it will do no harm; and this method will always 
clear the hands, face and neck of discoloration caused by 
blood there. Even though all discoloration from the same 
cause should not pass away from the legs or trunk of the 
body, it is no reason for worry, as enough fluid may in every 
case be used to disinfect thoroughly all blood remaining, and 
it will do so by the time the four signs referred to in Rule 
one appear. 

The artery of the arm or leg should always be injected 
towards the extremity. This should not occupy more than 
from three to five minutes. It will prevent any possibility 
of odor or trouble. Upwards of six ounces of fluid will be 
needed to properly care for an arm, and an additional 
amount in proportion to its size, for the leg. 

The bodies embalmed by this method show better results 
than by any other. The hollow needle should not be used 
either to remove gases or liquid secretions from the cavities 
or to inject fluid in any cavity until upwards of ten hours 
after the first injection, knowing that we could give a sec¬ 
ond injection in case it were necessary; that is, in case any 
part of the body should at that time remain sott and need 
more fluid, it then could be treated, as the systemic circula¬ 
tion would not have been ruptured and parts of a body will 
receive fluid at a second arterial injection that had not re¬ 
ceived any at a first. 

After about ten hours, in bad cases of cystic tumor, dropsy 


74 


or secretions in the cavities, remove the cause of the trouble 
by aspirating and injecting some fluid in such cavities. 

Reasons for not using the hollow needle when the body 
is first embalmed are these: 

ist. No person can tell what injury he may do to the 
systemic circulation by its use; if he does not use it, he is 
sure that he has not caused any injury to it. 

2 nd. The circulation of blood in life keeps the tissues 
and all organs normal and in good order. Why should 
not this same circulation after death be established, using 
pure fluid in place of the blood, in this way driving out the 
blood, which will decompose quickly after death, and filling 
all spaces occupied by blood in life, (or nearly all,) with a 
positively good disinfecting fluid, which, in ninety nine out 
of every one hundred cases will prevent any later trouble, 
and this without any attention whatever to the cavities of the 
body or the contents of these cavities. 

To those who may criticise such work I ask, try it a few 
times, following this line of work, as advised, or until the 
signs I speak of appear up to or upon the neck. Do not 
continue injecting until you mottle the face. Stop when 
a firmness appears in the ears and a dryness comes over the 
entire body. Leave the case then and allow the gas “of 
any good formaldehyde fluid” to afifect the face during the 
next ten hours. It will do it every time, provided, you 
have not made a countless number of holes in the systemic 
circulation by using the hollow needle. If you have, said 
formaldehyde gases will follow the course of the least resis¬ 
tance and pass into some cavity through the perforation you 
have made; whereas, if the circulation has not been disturbed, 
they must, as they form, pass to the only unoccupied space, 
viz.:—the arteries, capillaries and veins of the head. “Try 
it before you condemn it.” 


A body so embalmed will improve every day. If it is not 
purging when these four signs appear it will not later. It 
may be kept in a warm room at any time of the year. The 
funeral can be arranged for any later day, up to one week, 
without any fear, or any further work. Can as much be said 
of bodies embalmed where a hollow needle is used? Cer¬ 
tainly not. As there may be much adverse criticism on this 
manner of work, I shall try to answer some critics now. 

First question. “Why use four to eight quarts of fluid 
when a body can be embalmed with three quarts?” 

Answer. Anybody can do that, but no living man can 
thoroughly embalm or disinfect a body, and be absolutely 
sure that it will remain in a first-class condition two or more 
days, unless he use as much fluid as suggested. Partial 

embalming may be done with one pint of fluid to each one 
hundred pounds of flesh. Thorough embalming cannot. 

Second question. “Why occupy from one to two hours, 

when a body can be embalmed in thirty minutes?” 

Answer. Same as before. Anyone can partially em¬ 
balm a body in that time. Thorough and good embalming 

should take from one to three hours. 

Third question. “My patrons won’t let me work over 
their dead more than thirty minutes.” 

Answer. If you draw blood by using the hollow needle, 
your patrons wouldn't let you work over their dead thirty 
seconds, if they saw you do it. Try inviting them to remain 
and see you embalm their dead in a neat, scientific manner, 
and possibly you will be surprised to learn how interested 
they will become, and how they, the patrons, doctors, nurses 
and others, will compliment you on your manner of work. 
You will hear such compliments about this method of work, 
and you are safe in allowing any who desire to remain or 
enter the room during the work. I cannot remember re- 


76 


ceiving one compliment on my “skill'’ as an embalmer from 
anyone who, years ago, watched me perform the operation 
of drawing blood with the hollow needle by puncturing the 
heart or vena cava. 

HOW TO INSERT DRAINING TUBES. 

In accomplishing the results as described above by the 
use of the Genung-Eckels draining tube it is essential that 
this instrument be inserted in the axillary vein, (high up 
in the arm pit), passed through the subclavian, opening or 
passing through the valves of the axillary and subclavian 
veins, and also passing through and beyond the valve located 
in the subclavian vein outside the point at which the jugular 
vein unites with the subclavian vein and forms or empties in¬ 
to the innominate vein. These valves, being the only ones in 
the veins between the point of opening of the axillary vein 
and the right auricle of the heart, the venous blood of the body 
should pass out, or be forced out by the injection of fluid 
into the arteries, thereby causing a pressure through the 
capillaries and forcing all blood from all parts of the body 
to the right auricle of the heart, in the same manner as this 
blood flowed in life; and, as there is this unobstructed pas¬ 
sage, the blood should flow freely out of this tube. It will do 
so through the Genung-Eckels tube better than through any 
other tube for the reasons already given. In using this or 
any other tube the operator should use common sense and 
good judgment. To avoid the liability of soil to clothing, 
board or couch, or to the carpet, he should always carry 
with him a piece of rubber cloth, say two to three feet wide 
and four to six feet long. Place the end of this under the 
body or between the body and board, couch or bed. The 
end of the rubber cloth on the floor is a desirable place for 
soiled instruments, soiled cotton or cloths. It is an easy, 
simple matter to cut all clothing, if necessary, at the back 


// 


of the neck, and this will allow all to slip over the shoulder, 
off the arm, and all such clothing can be placed over chest 
and need never be soiled if this precaution is taken. Always 
place the arm at right angles with the body, palm of the 
hand toward the feet. Make incision and raise axillary 
vein. Ligate same at the lower end of the opening. This 
will prevent blood from the arm escaping and creating any 
soil. Place ligature around the vein at the upper end, from 
one to one and one-half inches above the lower ligature. 
Merely place this under the vein; do not tie it until the 
draining tube is inserted the desired distance. By raising 
gently on the ends of this ligature any escape of blood will 
be prevented. Make an incision in the vein, half severing 
it, just above the lower ligature. Introduce the ends of two 
pair locking (spider) forceps. Cut the vein lengthwise 
through one side between the jaws of the forceps. The 
vein can be held better by using the forceps. Select the 
size of draining tube needed for the vein. Place the plunger 
or cleaner inside it and insert in the opening in the vein. 
Relieve the tension on the upper ligature around the vein and 
continue to insert the tube. Should an apparent obstruction 
be found, change the position of the arm a little and move the 
end of the tube upward, downward, to right or to left, when 
it should always enter the vein easily; always insert drainage 
tube until the end has passed the valve near the jugular 
vein. Never use force enough to rupture the vein. In case 
the vein is bifurcated into several small veins, or serious 
obstructions should prevent its introduction, remove the 
- tube, ligate the vein, sew up the incision, and repeat the 
work in the other arm; as bifurcations rarely occur the same 
in both arms. This will not be necessary, however, one in 
one thousand times. Often when the vein is first exposed, it 
looks very small. Do not be discouraged: proceed as di- 


78 


rected, and after the forceps are in place and the vein opened 
a little, lengthwise, you will always find it much larger than 
you at first supposed it to be. After the tube is inserted, 
ligate it firmly, using a surgeon’s knot at all times, leave 
the ligature long enough to tie the ends around the post 
at outer end of the draining tube. This will prevent its 
being drawn out of the vein while the blood is draining. 
Remove all objectionable discoloration possible, by manipu¬ 
lation, (before injecting any fluid.) Massage carefully all 
exposed parts of the body where discoloration appears. Wet 
the face, neck, and hands, using water on your hands, or 
better still, a damp, soft bath sponge, carefully stroking face 
and neck downward over the line of the jugular vein. This 
should always increase the flow of blood. Be sure, by in¬ 
serting the cleaner, that the tube is not stopped by clotted 
blood and that the rubber blood tube is open and free of ob¬ 
struction. You should never under any circumstances use an 
aspirator on the draining tube. Let the blood flow out if it 
will. If not, force it out by pressure of fluid through the ar¬ 
teries and capillaries. I realize that there are as many different 

manners of embalming dead bodies for funeral purposes as 

« 

there are different kinds of embalmers, or rather, different 
classes of embalmers. We ocasionally meet a man who 
thinks that a goodly quantity of fluid should be used to thor¬ 
oughly disinfect a body. We meet others who think that 
four quarts of fluid is a goodly quantity to use in any dead 
body. Others whom we talk with reduce the quantity to 
three quarts, and so on down, until we find some who insist 
that they can embalm a body with one pint of fluid. There 
are mercenary reasons for embalming the dead in a thor¬ 
oughly good manner, in addition to the natural desire to 
produce good results, as this is the best means of adver¬ 
tising. 


79 


It is an admitted fact that some dead bodies will show 
marked signs of putrefaction within ten hours, and others 
not until after a number of days. Could we always cell the 
latter, we need not inject in them any fluid, while the former 
we should embalm thoroughly. As you cannot positively 
foretell the bodies that will go to pieces quickly, you should 
not take any chances, but thoroughly embalm all. If the 
Genung-Eckels draining tube is used properly, and fluid of 
a good preserving quality injected until its presence is ap¬ 
parent in all parts of body, producing the four signs alluded 
to in Rule one, a successful preservation without any chances 
of failure is assured, even though you may hold such cases 
a number of weeks. Can so positive a result be obtained in 
any other way, than by a thoroughly scientific circulation of 
the fluid to and through all parts of the body? Following 
the course which we are taught the blood flows in life, we 
all know the normal circulation of the blood in life would 
be stopped if any arteries were ruptured or punctured— 
why should we expect less if we cause this ruptured condition 
to the same circulation after death by using any “hollow 
needle,” before this complete circulation of fluid has been 
accomplished ? 

WHY DRAW BLOOD? 

The question of the advisability of drawing blood has for 
many years occupied the attention of all thinking men who 
have practiced the art of embalming. A few maintain that 
it is not necessary; others, that it should always be done. 
The most pronounced failures known in the past few years 
have occurred where bodies have been embalmed and no 
blood withdrawn. The best and safest way is always to be 
ready to drain blood should occasion arise. The Genung- 
Eckels Draining tube can be inserted into the axillary vein, 
withdrawn and the vein ligated, in less than three minutes 



So 


bv an expert embalmer. By placing a rubber tube of con¬ 
venient length, fitted with cutoff, on to the draining tube, 
blood can be allowed to pass out of the body in the most 
scientific, as well as the most practical manner, at any time 
the embalmer should deem it advisable. Should the first 
three signs mentioned in Rule one appear, and the color of 
the body be life-like, the embalmer need not allow any blood 
to escape. It would be better, however, in such a case, to 
allow all blood that would, to pass out at this time, and 
inject some fluid into the venous circulation, as an additional 
guarantee that the blood left in the body is more thoroughly 
disinfected. In all sudden deaths this method is the safest 
to employ. In bodies dead of uraemia, the venous system, 
the capillaries, and the arterial system are often found nearly 
full. It would be utterly impossible to inject enough fluid 
into such a body to disinfect it without removing some 
blood, even though the condition of the case at the first 
examination should not indicate the necessity of removing 
any blood. In such a case, an injection of only one pint of 
fluid would show a distension of the temporal and jugular 
veins, often given as an evidence of proper embalming. 
Should such conditions arise, merely open valve in cutoff 
and allow blood to be forced out of arteries, capillaries 
and venous system, through the draining tube in the vein, 
regarding the work as complete and perfect only when the 
four signs given in Rule one, appear. Under no considera¬ 
tion should you aspirate when using a vein tube. Such an 
act would surely collapse the flexible vein around the open¬ 
ings in the vein tube and prevent its allowing the blood 
to flow out. It is better to force the blood out by the pres¬ 
sure of fluid through the arteries and capillaries upon the 
blood in the veins of the body. Such pressure must cause 
the blood, or blood and fluid, to flow to the “well” of the 


8i 


body, the inferior vena cava, the right auricle of the heart, 
superior vena cava, right and left innominate veins, and 
thence out of the draining tube. 

There is often a small quantity of blood in the arteries, 
but not enough to cause flushing of the face by using any 
artery for injection when blood is allowed to pass cut 
through the draining tube. Even when using the femoral or 
iliac artery, injecting toward the face, this flushing will not 
occur providing you follow Rule one, and inject not faster 
than one quart in ten minutes. 

We must admit that some fluid may pass out with the 
blood, but the fluid loss is so small compared with the good 
results obtained, that any embalmer can well afford this loss. 

Good embalmers drain blood in this scientific manner from 
a vein of the body, so as to be able to ligate the opening 
made in the venous system. For many years the only avail¬ 
able instrument was the flexible silk catheter with an open¬ 
ing in the end. With this instrument success could be ob¬ 
tained in cases where very little fibrin was present in the 
blood, but this instrument proved nearly worthless where 
much fibrin was present. Later the spiral draining tube, 
long enough to enter the femoral or basilic vein, and reach 
the right auricle of the heart, was used. At times this could 
be done successfully, and at other times it could not. On 
account of this trouble, they have in the last few years been 
made of various lesser lengths, but there still remain hind¬ 
rances to their being used with marked success by the aver¬ 
age practicing embalmer. They are easily broken and wear 
' out in use or by cleaning; frequently they cannot be with¬ 
drawn from the vein after the body has been embalmed, 
but must be buried with it. Their introduction is always 
accompanied by a greater or less escape of blood, causing 
soil. 


The Genung-Eckels draining tube is offered to the em- 
balmer as an instrument that does not possess any of the 
above faults. It can be introduced easily at all times, and 
should never wear out. It will drain as much, if not more 
blood than any other instrument, and should it become 
clogged, may be opened the full diameter of the aperture 
without withdrawing it from the vein. It can be introduced 
through the iliac vein and drain the blood from the body 
as well as. any other instrument, although the inventors do 
not recommend the use of this vein for the purpose, pre¬ 
ferring to use the axillary vein for the reasons given else¬ 
where. 

p 

INJURY TO the circulation done by using the hollow 

needle. 

I cannot imagine a case where the hollow needle should 
be used before we have thoroughly embalmed the body. It 
may possibly be used and not destroy the proper circula¬ 
tion of the fluid; still it would be better first to obtain that 
circulation. Then we are positively sure we have not de¬ 
stroyed it. 

Scientific as well as practical embalmers of the present day 
who have used the cardiac needle, hollow needle, or trocar 
(call it by whatever name you may) to draw blood from the 
right auricle of the heart or the superior vena cava, and 
have afterwards traced to its use the injury done to the vas¬ 
cular system, will agree that no one can be sure that he has 
not caused an injury to the circulation. These blood 
vessels are out of sight of the operator, and are so thin and 
delicate of construction that the act of puncturing them 
by any sharp-pointed instrument could not be noticed 
by the sense of feeling in the hand of the operator at the 
other end of the instrument. Ninety-nine times out of 


83 


every one hundred an injury to the arterial circulation will 
be found should you take the trouble to open the body and 
follow the track of the hollow needle. 

Having examined many such cases, even after some ex¬ 
pert embalmers had inserted the hollow needle, I have seldom 
found a case where the expert had accomplished the punc¬ 
turing of the venous circulation as he thought. In nearly 
every case, the arterial circulation had been ruptured by 
the hollow needle. In each of these latter cases, embalming 
fluid injected through an arterial tube having an opening 
less than one-eighth of an inch in diameter, would find a 
ready escape out of the opening, say one-quarter of an inch 
in diameter, which was made by the hollow needle, and the 
entire amount of fluid usually injected could be contained 
in the thoracic cavities, and great quantities of this fluid, 
mixing with a small quantity of the blood of the body may 
be aspirated, and often considered by the operator to be ven¬ 
ous blood. Should the embalmer puncture the venous cir¬ 
culation only, he has done an irreparable injury, as he is 
unable to close the opening or puncture at this or a later 
time. Granting he had produced a life-like looking body 
by his embalming, the life-like color of the face being pro¬ 
duced by the blood and fluid filling the capillaries, this blood 
and fluid, by the law of gravitation, would settle through 
the veins awav from the face, leaving it pallid or of a lighter 
color, to a lower point, and escape into the cavities around the 
heart, through the openings made by the hollow needle. On 
the other hand, when the same life-like condition is pro¬ 
duced by following the method advised in Rule one, the in¬ 
cision made in the axillary vein, being ligated when the 
draining tubtf is removed, leaves the circulation intact and 
complete, as before operation, and no change whatever can 
occur. Moreover, at any later time, fluid may be injected 


84 


into the systemic circulation as successfully as it was at the 
first injection, without causing any escape; whereas, if any 
opening before made by any hollow needle existed, it always 
remains an open door and ready means of escape from the 
systemic circulation of any fluid at a later injection. 

CHEMICAL ACTION OF EMBALMING FLUIDS. 

Some claim that certain fluids by the “chemical action” 
cause a life-like appearance even when great discoloration 
exists. This abnormal color is caused by the blood remain¬ 
ing in the capillaries and will always disappear when this 
blood is removed either by manipulation, by massage, or by 
forcing it out of the capillaries into the veins by pressure of 
any fluid, without regard to its “chemical action.” 

Tests to substantiate my claims are easily made. Try the 
following test on the first body you embalm. Raise both 
iliac or femoral arteries and inject one leg downward with 
a quantity of such “magic acting fluids," and then inject the 
other leg downward with a like amount of any good disin¬ 
fectant fluid. You will find just as much “magical chemical 
action” in one leg as you do in the other, as in each case 
you will drive out the blood contained in the capillaries by 
forcing it into the veins of the body, and as the same occurs 
in each leg, the results are likely to be the same. Water will 
do as well and perform as great a “chemical action” as any 
embalming fluid, but it would be a poor fluid to disinfect 
the tissue. - 

THOROUGH DISINFECTION OF THE DEAD BODY, TO PRESERVE IT 

FOR AN INDEFINITE PERIOD. 

* 

Thorough disinfection of the body can only be obtained 
by injecting enough fluid to permeate all or nearly all tissues 
of said body. In such cases, use the draining tube, as 


\ 






















85 


the surest way to obtain this result, without any regard to 
the condition of the organs of the body or the contents of 
the cavities. Proceed to embalm the body as directed in 
Rule one, and by proceeding further as described in Rule 
two, proper care and disinfection of the cavities of the body 
can be secured, without the use of anv hollow needle, and 
all foreign matter and gases may be removed without any 
puncture being made through the walls into the cavities, 
which is likely to cause trouble. Employ this method in 
cases of long-time preservation, for the following reasons: 
By leaving the arterial tube in the body, you can inject as 
much fluid as you desire at a second or third injection on 
subsequent days. Be sure, in all long-time preservation 
cases, to remove enough blood. It is best to remove all the 
blood possible before injecting any fluid. Great quantities of 
blood may be forced out by changing the position of the 
body and by constant application of pressure or manipula¬ 
tion. If you do this after you start the injection of the fluid, 
and the color of the blood passing out becomes lighter, you 
may think the blood so passed out is part fluid. If done 
before any fluid is injected, you are sure it is all blood and 
secretions of the diseased body. 

Good judgment, however, should be used with the care of 
this body in after days, weeks, or months. I firmly believe 
that the Egyptian mummies were produced chiefly because 
the soil and climate favored desiccation. The lack of humid¬ 
ity was the chief reason that the bacteria of putrefaction did 
not form; so should we be sure that our bodies, after being 
thoroughly disinfected, should not be subjected to great 
humidity, but rather, that they should be kept in a dry room 
where the temperature is at all times above freezing, as 
humidity will surely produce mould, even on the best pre¬ 
served or embalmed dead tissues. As a preventive against 


86 


this condition, I would suggest that all such cases be pro¬ 
tected in the following manner: Coat the face, neck, hands 
and wrists with a heavy coating of vaseline from one-eighth 
to one-half inch in thickness. Cover the entire form, includ¬ 
ing the clothing, with pieces of lintine or absorbent cotton 
before placing such body in any receiving vault. Later this 
coating of vaseline may be removed (by using ether, grain 
or wood alcohol) and the condition of the tissues be found 
in each and every case without any change, other than the 
change of desiccation. 

Concerning this change, I would say that it may occur 
on bodies at varying times, within three days after death, 
or not until after months. While this mould formation may 
not be an indication of decomposition, it surely is very un¬ 
pleasant, and can be avoided by following the above instruc¬ 
tions. 

treatment oe dropsy cases. 

Some still maintain that it is necessary to leach the limbs, 
and in that way remove the liquid secretions from the tissue 
in dropsy cases. 

If you use an embalming fluid that does not contain for¬ 
maldehyde, I would advise the same method of work, as 
without formadehyde, you could not harden the liquid secre¬ 
tions and would be obliged to let it drip out. It would, anyway, 
whether you leached the limbs or not. Blisters would form 
now, just as they did years ago, if we used the same kind 
of fluid we did then. That is why we use formaldehyde 
fluids now to, care for such cases, and it is why we do not 
have the blisters and other troubles. 

We may by the use of rubber bandages drive the liquid 
secretions from the tissues of the limbs into the vascular 
system, and such liquid secretions will pass out through the 


87 


draining tube in the axillary vein. For a long time I have 
practiced and demonstrated this work, and after considerable 

4 

investigation of this subject, and consulting some of the best 
students of physiology in the United States, I am convinced 
that the result we produce by this pressure is to force the 
dropsical fluid from the tissues themselves into the lymphat¬ 
ics, and that it, together with the fluid already in the lym¬ 
phatics, is forced up through the internal and external super¬ 
ficial and deep lymphatics of the leg. These communicate 
with the lymphatics in the pelvis and abdomen and unite 
with the thoracic duct, which enters the sub-clavian vein at 
its angle of junction with the left internal jugular. After 
this fluid has passed into the sub-clavian vein, it cannot re¬ 
turn into the thoracic duct because of the valve at the end 
of that duct. 

The fluid forced into the sub-clavian vein by the pressure 
of the rubber bandage follows the course of least resistance, 
and passes out through the draining tube, which has been 
inserted through the axillary and sub-clavian veins. Should 
there be a right branch of the thoracic duct, as there some¬ 
times is, it empties into the right sub-clavian vein, from 
thence into the right innominate vein, which joins the left 
innominate vein and with it forms the superior vena cava. 

This lymphatic system is the sewer of the living body, 
carrying off all waste matter. The pressure of the Esmarch 
bandage drives the dropsical secretions that lie in the inter¬ 
stices of the connective tissue, and in these spaces is the 
commencement all over the body of the lymphatic system. 
The pressure would tend to force open the lymph radicals, 
and most, if not all, of this dropsical fluid would be forced 
up and into the venous system through the lymphatic circu¬ 


lation. 


88 


cranial method oe embalming. 

The use of any cranial method of embalming the dead is so 
disgusting to any embalmer that none practice any of these 
methods more than a few times. Any one is justified in 
arriving at this conclusion, as in no case can any desirable 
results be obtained by their application that could not by a 
thorough arterial injection, using any of the arteries gener¬ 
ally used by embalmers. 

Surely, the application of any cranial method would be 
objected to by all our patrons who had a spark of sentiment 
or affection for their dead. Such uncalled-for mutilation of 
the head should not be practiced by any embalmer, under 
any circumstances, at any time. 

* 

FUNDAMENTAL RULES FOR PROCEDURE WHEN 

EMBALMING THE DEAD. 

RULE ONE. 

Insert the Genung-Eckels draining tube in the axillary 
vein; allow blood to pass out until the color of body is life¬ 
like or natural, injecting fluid through an artery, preferably 
the axillary or the iliac. When the artery is chosen, always 
inject toward the hand or the foot enough fluid to cause 
the arm or leg to become dry and firm. Then inject fluid 
through the same artery towards the trunk of the body, not 
faster than one quart in ten minutes, until the following four 
signs appear: 

ist. The surface of the body becomes dry. 

2d. The flesh becomes firm. 

3d. A mottle caused by the fluid used spreads over the 
body. 

4th. Fluid with the blood escapes through the draining 
tube. 


8 9 


Stop injecting fluid and remove the draining tube when 
the first three signs appear over the body up to the neck 
and ears, provided the color is normal. If the color is still 
too dark, allow blood to continue to pass out of the draining 
tube until the exposed parts of body are life-like in color. 
Then remove the draining tube and ligate vein. Leave the 
arterial tube in the arterv directed towards the body until 
you can examine body, say, ten hours after first injection. 

Remove artery tube directed towards the arm or leg, at 
the same time you remove the draining tube at completion 
of the first injection, ligating the artery when you remove it. 
After ten hours examine body. If it is dry all over the sur¬ 
face, and a firmness of the tissue is apparent all over the 
body, it will not need more fluid for a preservation of say 
one week. Should any parts of the body be soft and damp, 
inject enough fluid to cause those parts to become dry and 
firm. When all parts of the body are dry and firm, remove 
the arterial tube. Should you be called upon to hold body 
longer than one week, I would advise a second injection of 
fluid at from ten to twenty hours after the first injection. 

After the entire body is dry and firm no harm could be 
done by using the hollow needle in any or all cavities, re¬ 
moving gases or any secretions from them and injecting 
them with fluid. It will be found unnecessary, however, 
in most cases. 

The amount of fluid needed to produce the above four 
signs will vary from one quart to fifteen pounds to one quart 
to fifty pounds of the weight of the body, providing that a 
modern embalming fluid is used in all cases. If an old line 
arsenical fluid is used, there are no such positive signs that 
will assure the embalmer that thorough disinfection has been 
accomplished. 

The embalmer should be sure the body has been washed, 


go 


and a wise precaution is to sponge the entire body with em¬ 
balming fluid. Always examine and find whether there has 
been any discharge from the anus. A quantity of absorbent 
cotton dampened with embalming fluid should be forced into 
the rectum, which prevents any further trouble. Always 
close the mouth and eyes properly before embalming. 

Carefully observe Rule two. 

RULE TWO. 

treatment where purging occurs 
without the USE oe trocar or hollow needle. 

All purging from the lungs or from the stomach is caused 
by fermentation of the secretions contained therein, or from 
leakages of the embalming fluid, into these cavities, or from 
the secretions and leakages of fluid in the stomach or ali¬ 
mentary canal, forced from thence by gases; and may be 
stopped by producing pressure on the cavities (the thoracic 
or the abdominal cavity) so as to drive the secretions, gases, 
or fluids into the throat, and from there they may always be 
aspirated into a bottle. When such purging occurs, stop 
the injection of fluid and aspirate through a nasal tube, (a 
flexible silken catheter, with opening about one-quarter of 
an inch in diameter, being preferable, as it can be bent into 
such shape that it may in all cases be inserted into the throat 
through the nostril,) manipulating the epiglottis by pressing 
it first to the right, then to the left. This will always allow 
the secretions and gases forced up through the alimentary 
canal or bronchial tubes to pass into the throat and from 
there may easily be aspirated into a bottle. This result is 
best produced by elevating the foot end of the embalming 
board or couch, while pressure is applied to the body as 
above described. By following this rule NO rupture of 
the systemic circulation will occur and all can be accom- 






GRAVITATING FLUID INTO THE AXILLARY ARTERY IN BOTH DI¬ 
RECTIONS, AND DRAINING BLOOD WITH THE 
GENUNG-ECKELS DRAINING TUBE. 










9i 


plished by this method that could be by using the hollow 
needle. 

With bodies purging after the four signs of Rule one 
appear, there is no objection (excepting in cases of long¬ 
time preservation) should the embalmer desire to use the 
hollow needle, as he would not aspirate the fluid from the 
tissues or capillaries, because the astringent properties of a 
formaldehyde fluid are so great that, having entered the 
capillaries or tissues, it could not be withdrawn. 

autopsiEd bodies. 

Autopsied bodies and cases in which the arterial and 
venous circulation have been ruptured or where such leak¬ 
ages occur, caused by gun-shot wounds, railroad or other 
accidents, should be embalmed in such manner that all parts 
of the tissue would receive enough fluid to disinfect it. This 
can be done only by injecting fluid towards the extremities 
of the body through the arteries which supplied these parts 
with blood in life. To embalm the face and head inject 
through the common carotid arteries. Always use both of 
these when caring for the head. Raise both axillary arteries 
and inject towards the hands. Raise both iliac or femoral 
arteries and inject towards the feet. Should there be an 
incision large enough, sponge out all secretions, blood and 
fluid from the cavities, and fill the cavities with a strong 
formaldehyde fluid. Good results will be obtained should 
you place numerous pieces of absorbent cotton or lintine in 
various parts of the cavity, before you insert the fluid. Dry¬ 
ing compound may be used with good results, provided it is 
thoroughly distributed around all the organs. Sew up all 
incisions neatly and place a piece of lintine over all the incis¬ 
ions before the body is dressed. 

The entire tissue of the trunk may be disinfected by using 


92 


the long hollow needle, hypodermically injecting a goodly 
quantity of fluid throughout all of this tissue. 

Upon an autopsied body, or where there is a ruptured 
circulation, also with a case of venous congestion, or where 
tissue gases have formed, the carotid arteries are without 
a doubt the best to use in treating the face, as they only 
could carry fluid directly to the face. When the above con¬ 
ditions do not exist, they are no better than the axillary, or 
perhaps other arteries, for injection. Personally, I prefer 
the axillary, iliac or femoral arteries for injecting when fol¬ 
lowing Rule one. My reasons are given in the first part of 

this work. 

WHEN TO PROCEED TO EMBALM DEAD BODIES AND HOW TO 
OBTAIN THE BEST RESULTS EOR FUNERAL PURPOSES. 

Bodies dead of pulmonary disease, or any wasting disease, 
may show signs of putrefaction soon after death; also those 
dead of puerperal convulsions, peritonitis, appendicitis, 
Bright’s disease and fever, and cases where dropsy is con¬ 
tributory, should be arterially embalmed as soon after death 
as possible, as delay may cause additional labor. 

The regulations in many cities are such that considerable 
time must necessarily elapse after death before the embalmer 
can proceed to embalm the body. In most cases delay em¬ 
balming from ten to twenty hours, as patrons like this delay. 
When you are called, especially at night, properly lay out 
the body and return during daylight to embalm it. Even 
though your eyesight is fairly good, you will have less trou¬ 
ble in daylight than working at night with artificial light. 

“life-like” color. 

Some embalmers pay little attention to the “natural, life¬ 
like" look of the tody they embalm, and are satisfied whether 


93 


it looks very pallid or is greatly flushed, and maintain that 
it is easy to paint or tint any body. 

The embalmer who desires to produce and retain a life-like 
color of the face and hands, should devote considerable time 
to manipulating those parts of the body before any fluid is 
injected. Continue this manipulation of the hands and face, 
if the color demands it, during the time the fluid is injected. 
Devote all the time necessary to produce this result. Hold 
the hands high above the body and carefully stroke the face, 
neck and hands to aid the blood to pass into the larger veins 
of the body, using sufficient time to obtain a good color. 

Concerning the necessity of more than one injection of 
fluid: If using an arsenical fluid, I should advise a second 
arterial injection if expecting to hold the case more than 
forty-eight hours; if using formaldehyde fluid, it is easy 
to obtain the desired results by the one injection. Gravitate 
the fluid in all injections, always use cutoff valves on both 
arterial and draining tubes; with them you have perfect con¬ 
trol of the circulation and can retain the life-like color when 
it is obtained and know that it will remain so, after ligating 
the artery and vein, provided you have used enough good 
fluid. 

THOROUGH DISINFECTION OF THE DEAD BODY. 

While this subject is one which many readers may not be 
interested in, and may assert that they are never called upon 
to preserve bodies for more than a few days, and feel that 
almost any kind of an arterial injection followed by thorough 
-cavity work, using the hollow needle and plenty of fluid in 
the cavities, will give them good enough results, still it is not 
the best method of embalming, and nothing but the best 
should be good} enough. Upon your next call you may be 
requested to preserve the cases many days or weeks. Then 


94 


only a thorough circulation of fluid to all parts of the body 
will produce this condition. The most expert embalmer 
cannot always tqll if he has accomplished this at the time of 
the first injection, but any embalmer may obtain by a second 
or third injection, provided he has not destroyed the circula¬ 
tion by using the hollow needle. 

POSITION OF BODY WHILE BEING EMBALMED. 

The position the body should occupy while being em¬ 
balmed depends upon how well you do your work. If you 
desire to follow rules one and two, using three or four 
quarts of fluid to produce the four signs, have the body 
nearly level, head slightly raised, in an easy, natural posi¬ 
tion. If you desire to embalm all bodies with three quarts 
or less it would be best to elevate the foot end of the board 
so that gravitation would carry some of the fluid to the head 
and shoulders. Should you inject only two or three quarts 
arterially, having the head end of board highest, gravitation 
would always carry most of the fluid into the legs and lower 
part of the trunk of the body. It will be seen that the first 
position and method is far the best. 

JUGULAR AND AXILLARY VEINS. 

Some hold that better results can be obtained by tapping 
the jugular vein than by inserting draining tube into the in¬ 
nominate through the axillary vein. The latter method is in 
reality so much neater operation that nothing is left to be 
said in favor of the former, while much may be truthfully 
said against it. 

First, no marked success in removing blood by tapping 
the jugular vein can occur unless some tube be passed 
through it as far as the innominate vein, as the valves at 
lower end of said jugular vein prevents the blood from 


95 


passing out, and when any tube is passed to this point, it 
has entered and drained the blood from the venous circula¬ 
tion, from the same part of this venous system as does the 
draining tube that is entered through the axillary vein. 

There are four jugular veins, the deep jugular, an¬ 
terior jugular, external jugular, and posterior jugular, on 
each side of the neck, eight veins draining blood from the 
neck, face and head into the innominate veins, where the 
Genung-Eckels draining tube is to be introduced. 

Secondly, this axillary artery, even on the stoutest per- 
son is close to the surface, and in stout people (the 
bodies from which we most desire to draw the blood) 
this operation becomes one that all embalmers can per¬ 
form in an easy and neat manner, while the axillary vein can 
be raised easily and neatly by the average practicing em- 
balmer. In fact, any person who has practiced raising it 
two or three times ought never afterwards to experience 
any trouble in successfully raising it and drawing blood, 
even on the stoutest bodies, and, as the results obtained are 
practical and scientific there remains no good reason why 
we should continue to cut the head of the bodies we are em¬ 
balming half off to get at the jugular vein when the same re¬ 
sults are to be accomplished by an incision, say, one inch 
long and less than one inch deep (usually about one-quarter 
of an inch deep) in the axilla. 

IN CASES OF PARALYSIS AND APOPLEXY (CEREBRAL HEMOR¬ 
RHAGE.) 

We have often been told that a leakage of fluid would 
occur and such bodies could not be successfully embalmed 
by the arterial method. While a leakage into the cranial 
cavity may occur, it is very beneficial, as it is really needed 

there to disinfect the blood that has escaped into the cranial 


96 


cavity and caused the death. Only a limited amount of em¬ 
balming fluid escapes and the leakage stops as soon as the 
cranium becomes full, as fluid does not readily escape from 
the cranial cavity; therefore, after this occurs, the condi¬ 
tions will be the same as in other causes of death, and can 
be embalmed the same as bodies dead from any other cause. 

CASES OF DEATH FOLLOWING AN OPERATION. 

Many embalmers are ready to advise quick burials in 
these cases, claiming if they attempt to inject them arterially 
the fluid would escape from the incisions the doctors have 
made. This is not true, and it is equivalent to an accusation 
that the doctors have caused the death of the patient by 
the hemorrhage through the leakages of the systemic circu¬ 
lation. Such a leakage or hemorrhage may occur for a short 
time when the operation is performed, but the hemorrhage 
soon ceases and does not exist in morbid anatomy after death 
following an operation. 

To properly embalm bodies where uremic conditions, fol¬ 
lowing acute or chronic nephritis (Bright’s disease) or any 
toxic condition of the blood (blood poison) exists, and in 
cases of puerperal convulsions, the embalmer should bear in 
mind that the veins of the body are usually filled to their 
greatest capacity; also that these bodies need prompt atten¬ 
tion. Nevertheless, all such cases can be more successfully 
embalmed by proceeding in a scientific manner, as described 
in Rules one and two, and much more easily and neatly than 
by proceeding in the old haphazard manner of punching the 
body full of holes by using a hollow needle. 

• In all such bodies, the blood, by the results of the disease, 
will be found much thinner than in deaths from other causes. 
In draining blood in such cases endeavor to remove all you 
possibly can before any fluid is injected. Aid your work by 








the gEnung-eckels draining tube. Extending beyond 

THE VALVES IN THE SUBCLAVIAN VEIN. 




97 


constant and careful manipulation over the greater part of 
the body, holding the hands and arms well above the body, 
and stroke over their entire length toward the trunk. Do the 
same with each leg. Change the position of the board or 
couch, first having the head end higher than the foot end; 
then raise the foot end, using a chair under each of the legs 
at the foot end, allowing the body to remain in this position 
as long as the flow of blood continues. Even though this act 
should slightly distend the jugular veins, this need cause no 
alarm, as all such distensions will subside very quickly, when 
the foot end of the board or coucn is lowered again. After 
all of the blood that will escape has been removed in this 
manner, the embalmer should proceed as directed in Rules 
one and two. 

This method will be successful in all uremia cases. The 
appearance of the four signs given is a positive guarantee 
of a successfully disinfected body. The embalmer may re¬ 
turn to his home and go to sleep, as he will not be obliged 
to watch the body or worry about it. Should occasion arise 
that the funeral services be delayed a week or so, he need 
have no anxiety. Merely make a second visit at any later 
time, and allow more fluid to gravitate into the systemic 
circulation, just as it did at the first injection. It will be 
impossible to over-embalm the body at the second injection 
by gravitating the fluid, using an elevation of not over four 
feet, as the capillaries all over the body, that had received 
fluid at the first injection, will have become so astringed by 
this time that they will receive very little, if any, at this, the 
second injection. Should, however, any part or parts of the 
body, capillaries, tissue, arteries or veins have failed to re¬ 
ceive the proper amount of fluid at the first injection, such 
parts may be so supplied at this second injection. This will 
be an additional guarantee of thorough permeation of all 


98 



parts of the body by embalming fluid, that had been occupied 
by blood in life. This positive result could not have been ob¬ 
tained at this second injection had the operator used the 
hollow needle in any manner at the time of-the first injection. 

We are told that the hollow needle is a good instrument 
to carry. So it is. Carry one with you, but never use it 
until you have caused to appear by the arterial injection the 
four signs of Rule one, even though you are compelled to 
resort to the method described in Rule two. It will pay you 
every time, by saving you much doubt and worry. It may 
cost you the price of a quart, or even two quarts, more of 
fluid than you have depended on to take care of bodies. If 
you have been in the habit of using two to four quarts in 
the arteries, and say, two quarts in the cavities, just try 
this method, and use the entire four to six quarts in the 
arteries, and let this arterial injection, by producing the four 
signs, take care of the cavities. “Remember the wise man 
is ever ready to be convinced and when convinced, to change 
his mind; the fool never.'’ 

Place a tape around the abdomen after following the di¬ 
rections of Rules one and two, and record the measure. I 
predict that the case will not measure as much at any later 
time. Try it before you condemn it. Should you embalm 
three or four bodies as advised in these two rules, the writer 
believes that you will not use the hollow needle again in 
one case out of forty, during the remaining years of your 
life as an embalmer. 

TREATMENT OF SPECIAL CASES. 

TO EMBALM A BODY DEAD EROM TUBERCULOSIS. 

Proceed as directed in Rule one. Should fluid escape from 
the mouth or from the nostrils before the signs appear, pro¬ 
ceed as directed in Rule two, carefully comparing the 


99 


amount aspirated with the amount injected each ten min¬ 
utes. You will be justified in continuing the injection of 
fluid so long as the amount injected is in excess of the 
amount aspirated until the signs do appear. If the amount 
of fluid aspirated equals the amount injected, it would signify 
that the leakage is so great, that it would prevent any fur¬ 
ther appearance of the signs of disinfection. In such a case, 
inject all parts of the body that have not become dry and 
firm by raising and injecting the arteries that will carry 
fluid directly to such parts. The right and left common 
carotids, to care for the head; the right and left axillaries, 
to care for the arms and hands. After this has been 

done, the shoulders and upper part of trunk may be 

* 

injected with the hollow needle, forcing large quantities of 
fluid directly into the tissues of these parts. Gently massage 
the parts until the fluid has been distributed throughout all 
the tissues of those parts. Inject all the fluid possible into 
the throat and allow it to settle into the alimentary canal 
and into the bronchial tubes to the lungs. This is a good 
way to do "cavity work” in such cases, and'will be all the 

treatment needed. 

However, if you prefer, use the hollow needle, and treat 
the cavities. 

peritonitis, or appendicitis (beeore or after operation.) 

Proceed as directed in Rule one, and should the body 
purge, apply methods' as directed in Rule two. As the seat 
of the trouble is in the abdominal cavity, this may be thor¬ 
oughly aspirated by using the hollow needle, and a good, 
strong fluid distributed throughout this cavity as an addi¬ 
tional precaution, should you deem it necessary; never, in 
any case, until the four signs of Rule one appear. 

tore 

• > ■> 
i j) 


100 


HOW TO EMBALM A CASE DEAD FROM PNEUMONIA. 

Proceed as directed in Rule one. 

A large percentage of cases dead from this disease are 
from heart failure following the pneumonia, and will need 
no other treatment, as they are normal cases. 

Should purging commence before the four signs appear, 
proceed as directed in Rule two. 

TO EMBALM BODIES DEAD OF SUNSTROKE OR HEAT CASES. 

Proceed as directed in Rule one. In case the body should 
purge before the signs appear, proceed as directed in Rule 
two. 

TO EMBALM A BODY DEAD FROM HEMORRHAGE- 

Proceed as directed in Rule one. Should a leakage occur 
that causes the body to purge, proceed as directed in con¬ 
sumptive cases. Ofttimes the astringent properties ot the 
fluid will, in a short time, so close or astringe the small ar¬ 
teries, veins or capillaries, the rupture of which has caused 
the hemorrhage as to allow all the signs of Rule one to ap¬ 
pear. If a leakage of fluid into the cavities where the hem¬ 
orrhage existed has occurred, such fluid is always beneficial, 
as it is needed to disinfect the blood that has escaped by 
hemorrhage into these cavities. In case any part or parts of 
the body fail to become dry and firm, proceed as in case of a 
consumptive; that is, raise and inject fluid through all arter- 
teries necessary to carry fluid to the extremities of the body, 
until such parts become firm and dry. 

TO EMBALM a BODY DEAD FROM CHILDBIRTH. 

To absorb any leakage, see that plenty of absorbent cotton 
or lintine is placed and bandaged against the vagina. This 
may be removed at any time should it become soiled. Pro- 


> «■> 

) i • 


IOI 


ceed to embalm the case as directed in Rule one. Should 
the case purge from the mouth or nostrils, proceed as direc¬ 
ted in Rule two. At the same time, create a pressure on the 
abdomen, which will displace gases or secretions from the 
stomach and drive them to the throat, and from there they 
may be aspirated. In case the child is unborn, it, together 
with the placenta, contained in the uterus (womb) may be 
thoroughly disinfected by aspirating from the abdominal 
and pelvic cavities, through the hollow needle, all gases and 
blood possible, and thoroughly injecting these cavities with 
a strong fluid. This need not be done until after the arterial 
injection has been done, as described in Rules one and two. 

CANCER, SARCOMA AND GANGRENE CASES. 

Proceed in all such cases as with any other dead body, 
following Rule one, until the diseased parts are thoroughly 
disinfected. A leakage may occur for a few minutes, but 
this will all stop in a short time. Place lintine or cotton 
saturated with fluid over the diseased parts and continue the 
injection slowly. Good embalming fluid is an astringent 
and will close in a very short time all small ruptured arteries 
or veins and capillaries causing the leakage. In all cases 
use enough fluid to produce a firmness of the tissue. Do 
not economize with your fluid. 

HOW TO EMBALM A DEAD BODY WHERE DROPSY SECRETIONS 

exist. 

Dropsy is not strictly a disease, but is produced by and 
is contributory to any disease that has caused an obstruction 
to the proper or normal circulation of the blood. Such 
bodies should be treated in different manners, as follows: 

ist. Pericarditis is dropsy of the heart sack. In these 
cases, proceed as in Rule one. After ten or more hours, 


102 


when all parts of body are found dry and firm, should the 
embalmer desire, he may introduce the hollow needle and 
remove by aspirating the dropsy secretions in the heart sack 
and inject a reasonable quantity of embalming fluid espe¬ 
cially prepared to be used in caring for dropsy cases. 

If necessary, make a second injection in the arteries ten 
or more hours after the first injection, always before using 
the hollow needle. Let this rule apply to all cases from this 
or any other cause of death. 

2nd. Ascites is dropsy in the abdominal cavity. Proceed 
as directed in Rule one. Should the body purge, follow the 
directions in Rule two. This purging matter is never the 
dropsy secretions from the abdominal cavity, but is the con¬ 
tents of the bronchi or the alimentary canal. After the four 
signs appear, lower the foot end of the board or couch to 
the floor, and allow the body to remain in this position until 
a second examination, ten to twenty hours later. Should any 
parts of the body be found soft and damp, inject at this time, 
through the arteries, enough strong fluid to cause all of the 
tissue to become dry and firm. Then or at a later time 
aspirate the secretions from the abdominal cavity, using the 
hollow needle (as no harm can be done by its use at this 
time). Inject a small quantity of strong fluid into this cav¬ 
ity, distributing it throughout all the parts. 

3rd. Edema is local dropsy and may be of lung tissue or 
any serous cavity or in any connective tissue spaces. 

Embalm such cases as directed in Rule one, applying 
Rule two, if occasion requires. , 

Afterwards treat the cavity affected, by direct aspiration 
and injection. 

4th. Pleurisy with effusion is dropsy in the pleural sack 
and should not be confounded with edema of the lungs or 
pneumonia. 


103 


While pressure as described in Rule two would drive the 
secretions of edema and pneumonia into the throat, it would 
not release the secretions in cases of pleurisy with effusion. 
Such secretions could only be removed by direct aspirating, 
using the hollow needle and puncturing the pleural sack. 
This use of the hollow needle may always be delayed until 
at a second examination of the body, say ten hours after 
the first injection, or when the conditions of the body show 
a second arterial injection to be unnecessary. 

5th. Anasarca is general dropsy. Proceed as in Rule one. 
It is wise, however, to pass all blood, or blood and dropsy se¬ 
cretions possible, from the body via the venous and lymphatic 
systems, out through the draining tube, before any fluid is 
injected. You will aid greatly in accomplishing this if you 
manipulate the parts of the body that contain the greatest 
amount of liquid secretion, changing the position' of arms 
and legs, at times holding them high in the air. Elevate the 
foot end of the board, applying Esmarch bandage, com¬ 
mencing at the feet and firmly wrapping the legs up to the 
trunk. The pressure of this bandage will in a very short 
time drive great quantities of the dropsical secretion into the 
lymphatic or venous system, or both, and it will escape 
through the draining tube, thus reducing the size of the 
parts distended (this may be done even though the skin of 
the arms or legs had burst before death) and make a space 
to be occupied by the fluid you may inject afterwards. Con¬ 
tinue the manipulation as the fluid is being injected, remov¬ 
ing Esmarch bandages before concluding the injection of 
fluid. The results as described by the four signs of Rule one 
may be obtained in all such cases, and any dropsical limbs be 
made hard and dry; provided, always, you use a strong 
dropsical fluid, one especially compounded to be used in em¬ 
balming such cases. Do not hope for such results if you use 


104 


a fluid that does not contain formaldehyde, or some yet to 
be discovered chemical that will care for liquid secretion 
equally as well as does formaldehyde. 

CHILDREN. 

In the case of those under six months old, cavity em¬ 
balming will be sufficient, as burial usually occurs soon after 
death. For cases six months of age or older, there is no 
reason why they should not be embalmed in the same manner 
and just as successfully as adults. 

The carotid arteries are large enough to raise and inject 
in a fully developed child at time of birth, even though the 
other arteries are very small. 

FUNERAL ETIQUETTE. 

The subject of funeral etiquette covers a field so broad and 
is one in which so widely different customs prevail, in vari¬ 
ous parts of the country, that the subject cannot be treated 
in a manner that would be applicable to all sections. How¬ 
ever, there are certain things connected with the manage¬ 
ment of a funeral that should be understood and receive 
much attention from all who claim to be undertakers and 
funeral directors. At the present time, the progressive, in¬ 
telligent undertaker is considered, by the average patron, 
the one who has charge of all the funeral arrangements; and 
as such it is a duty he owes his patron that he devote time 
enough and study the arrangements well enough to become 
master of the situation. He should be director of the funeral 
in fact as well as in name, and as such, should be held re¬ 
sponsible that every detail pertaining to the funeral passes 
off in a quiet, orderly manner, and should be willing to 
assume all responsibility for its being so, including the prep¬ 
aration that would guarantee a perfectly disinfected and 


10 5 


life-like looking body, furnishing a suitable casket and 
funeral furniture, all in keeping with the house furnishings, 
and should be the adviser on all questions apt to arise. As 
the funeral is constantly approaching nearer and still nearer 
a ‘‘social function”, the duties of an up-to-date funeral 
director are becoming more varied; in fact, we are now 
expected to direct all arrangements from the time of death 
until the burial has occurred, including the care of the body, 
announcement of death, notices and invitations to funeral, 
engaging clergyman, singers, bearers, ushers, carriages, 
flowers and opening of grave or vault. That all of the above 
things are furnished and proper attention given to all de¬ 
tails showing to all that there is a “funeral director” in 
charge of the funeral, and that the “funeral has not run 
itself,” is the demand of our patrons, and we owe to those 
patrons all of the above, when we engage ourselves to them 
as their funeral director. The undertaker, however, should 
not make himself unduly conspicuous at funerals; in fact, 
he should be just as little in evidence as possible, yet all 
arrangements should be closely studied by him, even though 
it should take many hours of his time prior to the funeral. 
Whether it be a large public one or the average home 
funeral, the funeral director in charge should have all ar¬ 
rangements so well planned, and his assistants so thoroughly 
instructed as to their several duties, that it will not be neces¬ 
sary for him to give any orders or be much in evidence at 
that time. 

While in many places the custom of closing the casket 
-before the arrival of friends and neighbors the day of the 
funeral services still prevails, I do not consider it a compli¬ 
ment to the deceased, the family or the widertaker. Some 
undertakers like this custom, as it is always their protection 
in case the body does not look as well as they would like to 


io6 

have it. With a properly embalmed body, I can see no rea¬ 
sonable objection to the casket being placed in such location 
that any who are received by the undertaker or bis assist¬ 
ants, either friends or relatives, may view the dead, if they 
desire, before they are given seats. It is preferable to close 
the casket before the services. 

It is convenient in most cases to place the clergyman in 
such a position that the entrance of late arrivals will not 
disturb him and he will appreciate it. I deem it “tact” to 
endeavor to please the minister. He can do you many kind¬ 
nesses, and possibly direct some calls to you. On the con¬ 
trary, he can make things very unpleasant for you, if he so 
wishes, and you cannot safely talk back to “one of the cloth.” 
So be sure to make him your friend. 

Concerning the charge of the funeral at the home, it is 
much better that the complete list of the relatives should be 
in your hands, so that you are familiar with the names prior 
to their arrival at the home, and that the position of these 
relatives, the carriages they are to occupy, should be quietly 
told them prior to the service. After the clergyman has 
finished the service, the undertaker and his assistants, having 
carried the casket to the bearers, they being previously sta¬ 
tioned on the outside, and after the assistants place the cas¬ 
ket in the hearse, the director has merely to inform the im¬ 
mediate relatives that the carriages are in waiting. It is 
not possible to give this attention in all cases, and in such 
instances the carriage list must necessarily be called. How¬ 
ever, the former way is far better. 

Concerning the handling of the funeral cortege at the 
cemetery, it is much better that the carriages pass the plot, and 
that the relatives and friends leave them there. The serv¬ 
ices should not begin until all carriages have passed away, 
nor are any coaches allowed to approach near enough to 


io7 


disturb any part of the burial service. The carriages are 
then brought up in the same order and leave the cemetery 
before anything whatever is done at the grave. While 
maintaining that the lowering devices are a great nuisance 
and expense to the undertaker, they, with the grave lining 
and the mound cover, give a very pleasing effect, and I have 
yet to hear any person express an objection or dissatisfaction 
because they are used. The only objection to their use is the 
expense and trouble to the undertaker. 




PART THIRD. 


Specific Instructions for Beginners. 







PART THIRD. 


SPECIFIC INSTRUCTIONS FOR BEGINNERS. 


TO EMBALM A BODY ARTERIALLY. 

To embalm a body there are certain rules to be observed. 
They are simple in the extreme, and, once knowing them, 
you will never forget them. 

In the first place, you are supposed to know if possible, 
what was the cause of death. Make selection of the artery 
to be used accordingly. Place your instruments in such posi¬ 
tion that you can reach any of them at will. See that every¬ 
thing you may require is in its proper position, even to the 
most minute articles. Decide which artery to use while you 
are selecting and placing your instruments. 

Your selections being made, take a seat convenient to the 
selected artery, and, with a deliberate and steady hand, mark 
the outline of your incision by cutting lightly through the 
skin. 

Having traced your work, force your way through the 
superficial fascia (or surface fat), taking care not to cut 
through the many little branches that are ramifying through 
it. 

When you have dissected down through the superficial 
fascia, you will come to the deep fascia. These fasciae are a 
protection to the arteries during life. Dissect through this, 
using the bone separator where you think there may be 
danger of cutting into any of the branches. 

After passing through the skin, the superficial fascia and 

109 




110 


the deep fascia, you come directly uopn the muscles of the 
parts which occupy their relative positions to the artery. 

The artery being in most cases very deep seated, you will 
need to exercise great care in selecting the place for incision. 
You must locate the two edges of the muscles through which 
the artery passes, and separate them either with the bone 
separator or with the fingers. 

You will find the vessels massed together, as it were, 
and running parallel with each other, perhaps half a dozen 
or more. Make your selection from this number, using the 
fingers of one hand, and pressing down with them a few 
inches distance from the point which you have selected for 
raising the artery, thus forcing the blood in the veins and in 
the artery to the point of selection, where you can see 
it distends the vessels. You can then easily distinguish 
it by its lighter red or pink color, the veins showing a very 
dark red, black, or perhaps a deep-blue color. 

As the walls of the veins are not nearly so thick as the 
walls of the arteries, the blood in the veins shows through 
much more plainly, and therefore appears darker. Arterial 
blood is aerated by its circulation through the lungs, bring¬ 
ing it in contact with the air in the lungs during life, so 
that the contrast is greatest soon after death, and after a 
body has laid for io hours or more, the color of the blood 
in the arteries is about the same as in the veins, therefore it 
becomes necessary for you to judge from other signs which 
is the artery and which is the vein. 

After you have made selection and separated the artery 
partially from its surrounding of fat, tissues, and accom¬ 
panying veins, with perhaps a nerve or two, place an instru¬ 
ment of some kind, it is immaterial which one, under the 
artery, and, using gentle force and due caution, separate it 
entirely. 


111 


Then, while your instrument remains under the artery, 
run your fingers across it, feel of it, and thus make sure you 
have made no mistake. You will soon become accustomed 
to the feeling of the artery, and, after a little experience, can 
select it by the touch alone. 

Next raise it to the surface, due care and caution being 
used here lest you rupture some little branch or vessel, caus¬ 
ing the blood to ooze out, making the operation very tedious 
and troublesome. Care only is necessary to prevent such 
accidents. 

After you have brought the artery to the surface, make 
another examination, as you cannot be too sure. Place the 
handle of an instrument underneath,- then make the in¬ 
cision, exercising care not to cut all the way and sever the 
artery entirely, for then each end, by reason of its elasticity, 
would withdraw out of sight. Work your way gently, and 
you will eventually penetrate the true canal. As soon as you 
do so, in all probability, you will see a drop of arterial, or 
light-colored blood ooze out. This completes the work of 
raising the artery. 

Your next step is to have the tube selected according 
to the size of the artery chosen, and insert it in the open¬ 
ing. Insert the tube well into the artery, pointing toward 
the trunk, if one of the lower arteries, and towards the heart 
if it be the Carotid. 

Then pass a ligature or thread around it, and tie perfectly 
tight. Have no fear of cutting the artery with the thread if 
you use no more than ordinary exertion. Then pass a liga¬ 
ture or piece of thread around the other end of the artery, 
well up, and leave the ends of the strings in such a position 
that you can pick them up at a moment’s notice. 

The usual directions at this point are to leave the other 
end of the artery open until blood and finally fluid flows out, 


I 12 


thus serving as a guide to know that that part of the body 
has been injected. This, however, is not a satisfactory test, 
because at the point of injection the artery is much larger 
than it is nearer the smaller branches at the extremities, 
which would be in no wise effected. From the light recur¬ 
rent pressure it is supposed to be sufficient to embalm them. 
It is true that the arm and hand seldom give any trouble if 

the body is buried within two or three days. This is because 
the substance is mostly muscular tissue, less liable to decay 
than the softer tissues of the body, or viscera, and when it is 
desired by the operator to be responsible for every part of 
the body’s preservation, it is very desirable that he inject 
this artery towards its extremity, and he will not only have a 
feeling of conscientiously performing his duty, but will 
have the best test possible that it is the artery that he 
has been injecting, when he has established capillary circu¬ 
lation by so doing. 

ARTERIAL EMBALMING COMPLETE, OR HOW TO EMBALM A BODY 

THOROUGHLY. 

It is desirable to remove the body from the bed to the 
embalming table, which should stand nearly level. 

Remove all clothing at once, and place over the loins a 
sheet in order to prevent exposure. 

Wash the body thoroughly, using an antiseptic soap with 
the water (hot or cold). When this is completed, and 
the body thoroughly cleansed, raise the board to an incline of 
about twelve or fifteen inches, the head elevated, the feet 
lowered, the object being to promote gravitation. 

SELECTING AN ARTERY FOR INJECTION. 

Usuallv, the artery should be selected after the cause of 
death is learned and the condition of the body considered. 


Having chosen which artery to use, dissect down until it is 
exposed to view, then raise the artery, and after entering the 
arterial tube as described on page in, it is advisable for the 
operator to always start the injection, the tubing or syringe 
having been emptied of air and filled with fluid before being 
attached to the nozzle. This is very important, because air 
forced into the arteries would interfere with the circulation 
at some region, so that it would shut off certain parts from 
the fluid. 

After the injection is proceeding nicely, the embalmer 
should turn his entire attention to watching the development 
of the capillary circulation. With a soft, moist sponge he 
can stimulate the circulation to any section or region. 

The ears and face should be manipulated constantly so as 
to have a free and uniform circulation of fluid. 

The finger nails and hands also should be taken care of, 
because they are the other exposed parts of the body for 
funeral purposes. It may be necessary to squeeze each finger 
nail forcibly, and manipulate it to encourage the circulation 
there, and have them nice and white, as they ought to be. 

Continue the injection until a quart of fluid to about every 
50 (pounds of the body has been used. 

If there is any swelling on the neck or distention of the 
veins, this is an indication that blood should be drained from 
the body, and if no previous arrangement has been made for 
the relieving of the blood by the vein tube, the Cardiac needle 
should be used between the second and third rib on the right 
side of the Sternum bone, rupturing either the Superior 
Vena Cava or right auricle of the heart, allowing the blood 
to drain away from the body. Continue thereafter to inject 
fluid until as much more fluid is injected as the amount of 
blood withdrawn. 

The arterial injection of fluid may distend the organs of 


114 


the trunk of the body so that the air and gas surrounding 
them are forced to the top, and the distention of the abdomen 
would show that these gases should be relieved. When they 
are relieved, it is always well to inject some fluid. 

It is well to introduce the perforated needle into the abdo¬ 
men at the umbilicus or navel, and keep its point near the 
surface, to rupture the transverse colon. This will surely 
relieve enough gas to stop purging, in the event that this 
purging is caused by this pressure, which is usual. 

Continue the arterial injection thereafter without further 
annoyance in this respect until it is concluded. After that, 
continue using the needle in the different regions of the ab¬ 
dominal cavity, following the point of the needle with your 
disengaged hand, over the abdomen. 

If the case is Consumption, Pneumonia, or Pleurisy, it is 
well to direct the point of the needle towards the left lung, 
in the direction of the back, aspirating whatever gases you 
may find there, and repeat the operation in the other side in 
the same manner, withdrawing the needle from that region, 
but not withdrawing it altogether from the body, because the 
one entrance in the abdomen serves all purposes. 

Then point the needle more directly in the abdominal 
cavity. Entrance to the stomach is gained through the punc¬ 
ture already made in the abdomen. Point your needle to the 
left and toward the upper part of the last or lowest rib. You 
will thus reach the stomach. Continue aspirating while you 
propel the point of the needle into all sections of the abdom¬ 
inal cavity. It is well to continue with the point of the 
needle near the surface, although always inside of the cavity. 

If the arterial embalming is already completed, no par¬ 
ticular fear of harm need be entertained. Perseveie until 
you are sure that all of the gases within reach of your needle 
have escaped. The abdomen will now become very soft and 


XI 5 

flabby. When this is the condition, the syringe or pump 
may be attached to the needle, and fluid injected in it until it 
is somewhat filled up again. 

It may be, by attaching the pump, that some gases will 
escape, after which the operation of injecting more fluid 
may give the best results. After i to 2 quarts of fluid have 
been injected well into the cavities, the needle may be with¬ 
drawn, and it is best to leave the aperture open. 

Now return to the artery, sew up the wound, and saturate 
white pieces of old muslin with fluid and place over the 
abdomen for disinfecting purposes. 

If it is a thin, shriveled body, it is well to dilute your fluid 
with water to one-third or one-half its strength, and cover 
the face and hands with it. This keeps them nice and fresh 
and moist, or, what is better still, a grease properly prepared 
will prevent the drying and shriveling and hardening, and 
leave the face in a more natural condition. 

Raise the hands over the chest or abdomen, and cover 
them as well. 

You now can rest assured that your work has been well 
done, rearrange your room and cover the body with slumber 
robe or canopy. 

CAVITY EMBALMING. 

Cavity embalming only, has been much criticised by prac¬ 
tical men, and owing to the very many failures resulting 
when it was the only kind of embalming done, the argument 
has become so strong against it that many undertakers de¬ 
clare that “they would never do it.” I presume that when 
they make the statement so emphatic, they mean that they 
never depend upon cavity embalming alone, and this.I most 
emphatically endorse, because any embalmer who knows any¬ 
thing about anatomy realizes that cavity injection alone does 


not affect any but that part of the body which the needle and 
the fluid pass through and comes into contact with. How¬ 
ever, cavity embalming is an essential adjunct to arterial em¬ 
balming, on some cases, particularly in sudden death, where 
the alimentary canal and stomach contain much vegetable 
substance. This is not disinfected by the fluid injected in the 
arteries, and to prevent it from fermenting and creating 
gases, which would be certain to produce very objectionable 
results, it is necessary to bring in contact with this vegetable 
matter, by the hollow needle, a sufficient quantity of fluid to 
thoroughly disinfect it. 

In the event that a body is to be buried before decomposi¬ 
tion or degeneration of the tissue is likely to occur in* the 

extremities of the body, hands, face, etc., and where the 
undertaker is in a great hurry, or until he becomes familiar 
with arterial injection, the following is the proper mode of 
procedure: 

Cleanse the mouth and raise the body to a half-sitting posi¬ 
tion, or, say, from twelve to fifteen inches. Wash it thor¬ 
oughly, using for this purpose one-half water and one-half 
fluid, or a disinfectant soap, then extract the gases from the 
thoracic and abdominal cavities by means of the long, blunt, 

perforated embalming needle; the upper or thoracic cavities 
being emptied of their gases first, later the abdominal. To 
do this properly, puncture a hole at the umbilicus( or navel), 
and direct your needle towards the right nipple. Then man¬ 
ipulate it, i. e., move it about in the cavity, and the gases 
will escape by aspirating. Press slightly on the breast to 
expedite matters. Withdraw your instrument, and direct it 
this time toward the left nipple, and repeat the manipula¬ 
tion. Never, however, draw the needle entirely out between 
the two manipulations, as the one puncture should answer 
all purposes; but be sure to keep your needle as near the 


ii 7 


surface as possible, as you can then feel and direct it with 
your free hand.- 

Care should always be exercised, as, should the needle 
enter the cavity too low down, the fluid would escape from 
the upper into the lower cavity, and thus ruin all your work. 

It does not require great skill to perform this operation, 
but it does demand care. Let your needle remain until you 
have injected the last cavity. 

A quart in each of the upper cavities,, making two quarts 
in all for the thorax, will ordinarily be sufficient. 

There is a septum, a division, separating these two cavi¬ 
ties, making an injection into each necessary. 

Now withdraw your needle from the upper cavities, as you- 
will have flooded the parts, thus preserving them as well as 
if they were enclosed in a vessel or bottle. 

On withdrawing the needle from the upper cavities, direct 
it into the stomach, and extract the gases from that organ; 
and so on throughout the whole cavity of the abdomen, 
pointing and puncturing in every direction. Puncture the 
intestines thoroughly, both the large and smaller ones, 
so as to be sure of releasing the gases from all the 
parts. While puncturing with one hand, pass the other over 
the parts where the needle is being driven, and press down 
on them until the abdomen becomes soft and flabby. This 
condition will serve as evidence that your work is 
properly done. Refer to the plates of the Aid for the loca¬ 
tion of the stomach if you are uncertain. It is located on 
the left side, under the lower ribs. Next inject the fluid, 
causing your assistant to do the pumping while you direct 
the needle. Point it straight into the stomach, and force, 
perhaps, a half-pint of fluid into that organ. Then with¬ 
draw from the stomach, and continue all around through 

the abdominal cavity. The puncture made into the intes- 


i iS 


tines will admit the fluid, and you will thus completely sat¬ 
urate the entire cavity, filling it to its capacity. When 
you have injected a quart, or a quart and a pint, detach 
your needle from the pump, and allow the gases that have 
been driven to the surface to escape. Assist them by pass¬ 
ing the hand gently over the whole surface. After complet¬ 
ing this operation a second time, inject more fluid; possibly 
a quart can be injected into the space made vacant by the 
passing off of the surface gases. 

Now transfer your operations, and inject a small quan¬ 
tity of the fluid down the throat and through the nostrils. 
To do this, (introduce a nasal tube or good-sized catheter 
down the nostrils into the passage, then attach the pump 
and inject a limited amount, say a half-pint. If the fluid 
will not pass down readily, seize the Adam’s apple, move 
it down and up, and, placing the other hand under the back 
of the neck, raise it, when the fluid will at once disappear 
down the passage into the lungs, and into the oesophagus, 
which is the canal by which the stomach is reached. Having 
now thoroughly embalmed the cavities, you may feel pretty 
sure of success, but it is always well to obtain some old 
pieces of muslin from the family, an old sheet for instance, 
the older the better; saturate with the fluid, and lay over 
the abdomen, covering from the lowest part to the highest; 
then lay a dry piece over the whole to prevent soiling or 
dampening the clothing. This will also act as a disinfectant, 
and guard against odors that might arise from gases ac¬ 
cumulating in the cavity. Leave the puncture open, that the 
gases may escape into this first outer piece of saturated 
muslin. It will absorb and destroy them, and also bleach 
the body to a certain extent. In any event, it is a good plan 
to follow, and causes no inconvenience, even should it re¬ 
main under the clothing with which the body is dressed. 


I have used it successfully, and can recommend it to all as 
a valuable addition to temporary embalming. Next give at¬ 
tention to the face and hands. For this purpose use the 
same fluid, but reduce to about one-half of its ordinary 
strength, i. e., about one pint of fluid to a pint of water. 
Place in a bowl under the cooling board. Saturate a small 
piece of muslin (though :a cotton mask is far superior, as 
it conforms to the features better), place it on the face, and 
spread all over it; but be sure the tip of the nose is not 
flattened, and see that it is thoroughly wet. Lay it very 
smoothly, so there may be no wrinkles. 

Next, wrap the hands in the same manner (muslin or 
lintine answers this purpose better than cotton), then place 
them on the breast to prevent discoloration by the blood 
which may gravitate downward. Leave the bowl of fluid- 
mixture under the board. Cover the body, leave it on the 
same incline, darken the room, and see that there is ample 
circulation of air. Return the next day and look over your 
work. Saturate your pieces of muslin and cotton again, and 
prepare the body for the casket ready for its interment. 
Cavity embalming is not recommended by practical embalm- 
ers, as failures are frequent, and it requires about the same 
time to accomplish as does arterial embalming. Arterial 
embalming is to be recommended even in the simplest cases. 
Do not assume, however, that cavity embalming is of no 
value. It is often of great importance and necessary, in 
conjunction with arterial embalming. 

LONG TIME EMBALMING. 

To embalm a body so that it will not change in appearance 
for an indefinite period, requires an experienced hand, an 
adept in the profession, and he is required to have good 
judgment, and a head full of strong common sense. 


120 


But, if the following directions be followed to the letter, 
there need be no hesitancy on the part of the em- 
balmer. In the first place, then, the body, having been re¬ 
moved from the death-bed to an embalming table prepared 
for its reception (which should be nearly level), should be 
disrobed of all its clothing so as to be wholly nude. Wash 
thoroughly with a solution of embalming fluid and water 
(warm or cold), after which throw a light sheet over the 
loins and extremities. The eyes should then be carefully 
closed, using eye-caps or strips of paper, extending from 
the upper to the lower lids, with the lids closed over them, 
care being taken that no folds or wrinkles are in the paper. 

Then a nasal tube should be passed into the nostrils, and 
fluid injected through them into the windpipe, so that it may 
reach the lungs. A pint of fluid will probably be sufficient 
for this, but the operator’s judgment must guide here, as 
there can be no inflexible rules laid down as to quantities, 
because of the variations in the size of the human body. 
The fluid introduced into the nose will also enter the ali¬ 
mentary canal, and pass down into the stomach, disinfecting 
the passages in its course. If, however, the fluid does not 
flow down easily and of its own accord, create an artificial 
deglutition (act of swallowing) by passing one hand under 
the back part of the neck and raising neck and head about 
two inches from the level of the board, using the other hand 
to work the epiglotis up and down. In this way the pas¬ 
sage will be opened, and the fluid passes down. Having 
completed this operation, which, by the way, is a very im¬ 
portant one, elevate the body on the table to a height of 
about fifteen inches, and proceed to raise the Axillary artery 
and vein. Place the tube in the canal of the artery, directed 
towards the body. Make that end of the ligature (or string) 
fast, tying it securely, thereby securing the tube in the canal. 


121 


Then attach the tube, and proceed to inject very slowly at 
first. The fluid, entering the artery, distributes itself through 
all the arteries and their branches at once, just what is de¬ 
sired. Keep up the injection slowly for a short time, yet 
making sure, by watching the course of the arteries, that 
they are receiving the fluid. Proceed with the arterial in¬ 
jection, progressing very slowly, as the fluid must be given 
/ 

opportunity to enter the minute capillaries and veins. As 
they receive the fluid they become distended. The process 
is slow and tedious, plenty of time and patience are re¬ 
quired ; see that the superficial veins are distended, your ob¬ 
ject being to reach all parts of the body through the arteries, 
capillaries, and veins, with as much fluid as possible. Con¬ 
tinue to inject until you have an amount of fluid which, ac¬ 
cording to your judgment, is sufficient for the time being. 

Then detach the tube, and place a cap or cutoff over the 
artery tube to prevent the escape of the fluid. The Axillary 
vein tube should be introduced at the same time with the 
Axillary artery tube, so that the blood may be drained at 
any time it is deemed advisable. 

Cavity embalming should be avoided, as there is always 
more or less danger of rupturing the systemic circulation. 
It is seldom found necessary, but if done, the greatest care 
should be observed in the use of the needle, not to rupture 
unnecessarily the arteries and veins, because, it may be that 
the reinjection of the arteries is needed; if it is also desir¬ 
able, however, to remove the gases from the body, and there 
is any great distention of the abdomen, and the pressure of 
the gases causes the walls of the abdomen to retard the cir¬ 
culation through its surface, but as the large arteries and 
veins are all deep seated, and lie near the backbone, the 
'operator may avoid rupturing them. He, therefore, is per¬ 
mitted to enter the needle. 



122 


Let me repeat, keep your needle as near the surface as 
possible, so as to avoid any leakage from the upper into the 
lower cavity through the diaphragm. Continue this opera¬ 
tion all around, as you did when puncturing the organs and 
intestines for gases. Use your own judgment as to the 
amount of fluid to be passed into the cavities, as you did in 
the case of the arteries. Ordinarily you should use, alto¬ 
gether, about six quarts on the first day. You next withdraw 
your needle part way, and permit the surface gases to escape. 
Probably they will pass off in large quantities. Then take 
some old muslin or towels, and saturate them thoroughly 
with the fluid, and then lay them over the whole abdominal 
surface next the skin. Now wrap the hands in two or three 
thicknesses of muslin saturated with the solution made for 
facial applications. It should be one-half fluid and one-half 
water. Dip the cloths in this solution, which should be kept 
in a bowl under the embalming table. Make a mask of 
cotton, and saturate with the solution. Place it over the 
face, fitting it to the parts by pressing it in and around the 
nose, and down upon the eyes, extending it from the top 
of the forehead to the chin, and down the neck, and from 
the back of one ear to the back of the other. Place the 
hands over the breast. Do not allow them to lie by the side 
of the body. Leave the room in good order, and the body 
in the same condition. Shade the windows until the room 
is dark, and see that there is a full circulation of air. As¬ 
sure the family that all is right, and state that nothing must 
be disturbed, and leave it until you call the next day, as it 
is better to keep the air from the face and hands for the 
first twenty-four hours. 

On your return the next morning remove the mask, and 
see that all is right about the face and hands; saturate it 
again: make thorough examination of the body: see that 


123 


the tube you left in the artery is in position, and that there 
is no leakage anywhere. Call again in the evening, and 
make another thorough examination, and moisten the mask 
(not too wet) and leave it for the night. Call again the 
second morning, and bring with you more fluid and your in¬ 
struments; inject the artery again with perhaps one or two 
quarts, as the case may be. Look to the cavities, introduce 
your blunt needle, and manipulate it in all directions. Ex¬ 
tract whatever gases have accumulated in the meantime; be 
sure of a thorough and complete examination, slighting 
nothing, even to the minutest detail. Withdraw the fluid 
from the cavity by means of your pump (as in dropsy), and 
introduce a fresh quantity, perhaps one to two quarts, thus 
destroying the possibility of more gases accumulating. Re¬ 
place the saturated towels, and see that the tubing in the 
artery is all right. See again to darkening the room, and 
continue the circulation of air; leave all in good order, and 
call the next day. By this time, all arrangements having 
been made for the funeral, you will be notified to that effect. 
Govern yourself accordingly. If there be no particular haste 
about dressing the body, leave everything as it is until you 
are ready to dress it for the casket. Just before dressing the 
body, saturate the towels that are on the abdomen, and 
leave them there. Put clothing on over them; sprinkle a 
little fluid around the bottom of the casket, among its lin¬ 
ings, or place some within at the foot, or do both. You 
might use the mask for face again if there is no glass to 
keep the air out. This is quite an important duty, as air 

will cause a change in some cases; therefore it is well to be 
on the safe side, and preserve the mask for use at any 
chance opportunity that may come to you as at night time, 
removing it in the morning. If everything is in order, as it 
should be, proceed with your final preparations. The body 


124 


can now be kept almost indefinitely, and may lie in state, be 
transported from place to place, or be shipped across the 
ocean and back. It should be in a perfect state of preserva¬ 
tion, and will not change in any way, if the face be kept 
from the air. Keep a glass over the upper portion of the 
coffin. 

FOR INFECTIOUS AND CONTAGIOUS DISEASES. 

The Board of Health rules are really those that should be 
used to generally guide you in the treatment of contagious 
and infectious diseases. In many places, however, the 
Undertakers are called on to exercise care and caution and 
to do the disinfecting. When this is so, the first thing to be 
done is the disinfection of the room and clothing with which 
he himself has personally to come in contact, and of which 
we will speak later. 

After having prepared the atmosphere so that it is safe for 
him to go in, the body should be removed from the bed and 
the clothing boiled in water for at least 20 minutes, or else 
saturated in a solution containing 1 part of corrosive sub¬ 
limate to 500 parts of water. To make one gallon of such 
solution use % oz. corrosive sublimate and % oz. of sal 
ammoniac, dissolved in the water (a gallon). The clothing 
should be allowed to remain in the solution a half hour. 
The body should be thoroughly bathed with a strong anti¬ 
septic solution, or with embalming fluid, which contains For¬ 
maldehyde, the orifices of the body closed with cotton satu¬ 
rated with embalming fluid, or with a strong antiseptic so¬ 
lution as above. A thorough arterial and cavity injection 
should be given the body, which should then be wrapped in 
a sheet which has been saturated with corrosive sublimate 
solution, and so kept until placed in the casket for burial. 


I2 5 


DIRECTIONS FOR DISINFECTING ROOMS, ETC. 

Close all windows and doors in the rooms to be disin¬ 
fected, also all large openings, radiators, chimneys, etc. 
Closing small cracks and very small openings, when there 
are but few of them, is only necessary in e'xtremely large 
rooms or wards. (Adhesive plaster is useful for closing 
small openings, etc.) The gas is generated so very rapidly 
in the apparatus that it has sufficient time and volume to 
kill all bacteria exposed to its action before enough of it can 
escape through minute crevices, or before it could have 
been sufficiently diluted by admixture with the outside air 

by ventilation through the walls of the room. The Glycer¬ 
ine, probably by preventing or very considerably retarding 
polymerization, and on account of its slight filmy (yet im¬ 
perceptible) deposit on the articles to be disinfected, appears 
to prolong the action of the Formaldehyde in its active state 
in immediate contact with the bacteria causing infection, and 
tends to favor bacterioidal action and penetration, even after 
the operation is completed. 

The linen, quilts, blankets, etc. (unless they have been 
removed for steam disinfection), should be stretched out 
on a line in order to expose as much surface as possible to 
the action of the gas. They should never be thrown in a 
heap. 

Curtains, furniture, hangings, gilt or tinselled ornaments, 
etc., need not be removed from the room, as Formaldehyde 
gas will not injure the color or material of any fabric used 
for room decoration, furniture, clothing, etc. 

Books supposed to have been infected by patient should be 
suspended by their covers, so that the pages are open and 
freely exposed. 


126 


Amount of Solution Required. 

For practical house disinfection, when the temperature 
of interior of room is not below the freezing point, io oz. 
by weight (8 oz. by measure) of solution are required for 
every 1,000 cubic feet of space. (If the infection is known 
to have been anthrax, use 20 oz. of solution per 1,000 cubic 
feet, a room 10 feet square with 10 feet ceiling. 

Rooms of 3,000 cubic feet and under should remain closed 
for at least three hours after operation of generator has 
been discontinued. Rooms of larger capacity, halls, wards, 
etc., should remain closed at least twelve hours. 

In cases of anthrax infection the room disinfected should 
remain tightly closed not less than twenty-four hours. 

The Formaldehyde or large retort has a capacity of a lit¬ 
tle over a half gallon, but should not be filled more than 
three-fourths full, so that space may be left for ebullition. 
If only a pint or quart is to be used in each room, vaporiza¬ 
tion (boiling) will occur more quickly if only such amount 
is put in the retort. When steam comes out of the stopper 
(the level indicator) it shows that the retort is almost empty, 
and should be refilled by unscrewing the cork, on the funnel- 
shaped opening of the top, which is large enough to serve 
as a funnel. 

The Alcohol Lamp holds a pint, which is sufficient to 
burn for three hours, or vaporize 3 pints of Foramldehyde. 
There is no danger in leaving this lamp full, though it 
should not run over. When filling, the burner is lifted right 
out of the lamp, when there is abundant opening for pouring 
into it. 




FORMALDEHYDE LAMP. 





































































































































































































































































PART FOURTH. 


The Embalmer’s Guide. 

f Designed to accompany Eckels' Anatomical Aid—Courtesy 
of the Western Publishing House.] 











PART FOURTH. 


The Embalmers Guide. 

[Designed to accompany Eckels’ Anatomical Aid—Courtesy 
of the Western Publishing House.] 

THE BLOOD CIRCULATION. 

In order to comprehend most fully and easily the art of 
embalming, it is essential that one should know something 
of the anatomy of the human body, its organs, and the func¬ 
tions or duties performed by each. This necessitates a brief 
examination of each part separately, and, as the blood is one 
of the most important, let us examine its work during life 
and its condition after death. 

Blood is a thick, opaque fluid, varying in different parts 
of the body from a brilliant scarlet to a dark purple color. 
In its normal state, it forms about ten per cent, of the bodily 
weight. Thus, if a man weighs one hundred and fifty 
pounds, the weight of his blood would be about fifteen 
pounds. 

The circulation of the blood throughout the body requires 
only about twenty seconds. It is carried to the lungs by the 
pulmonary arteries (5, Blood Formation) as venous blood, 
and is carried from the lungs to the left auricle (26) of the 
heart through the pulmonary vein (17), then carried to the 
left ventricle (28) of the heart, then to the aorta (4), and 
thence throughout the entire or general system. 

Within a few hours after death the blood becomes thick¬ 
ened or coagulated on account of its remaining quiet 


127 



in the veins. The arteries, as a rule, empty themselves 
into the veins, capillaries, and tissues of the body. There¬ 
fore, in preparing to embalm a body, we ordinarily find 
them empty, although, in some cases, small quantities of 
blood are retained. 

Water forms about seventy per cent, of the human 
body, and the remaining thirty per cent, is distributed 
among the tissues, the bones and other organs of the 
human frame. 

DESCRIPTION OF THE ARTERIES. 

(See plates in the Aid.) 

The arteries are cylindrical, tubular vessels, which 
serve to convey blood from both ventricles of the heart to 
all parts of the body. They are strong, elastic, and, when 
empty, preserve their cylindrical form, and are composed 
of three distinct coats: the internal serous, the middle 
fibrous, and the external cellular coat. The arteries are 
recognized by their pink color in strong contrast with the 
dark color of the veins, are of various sizes, some of them 
being of extremely large, and others of very small, caliber. 

They contain no valves, so that, when injected, they 
distribute the fluid throughout the entire system to the 
remotest corners. They will hold from two to six quarts 
of fluid, and often much more. During the embalming 
process the arteries may receive daily injections, using a 
small quantity at a time. Care should be taken that the 
injecting tube is placed in the canal of the artery, and not 
between the tunics or coverings. The arteries empty 
themselves into the capillaries, which are microscopic ves¬ 
sels, in diameter about one three-thousandth of an inch, 
their size varying in different parts of the body. The 
smallest capillaries are those of the brain and of the 


129 


mucous membrane of the intestines. Arteries are, as a rule, 
deep seated, in order that they may be less exposed to 
injury. 

The distribution of the systemic arteries is like a highly 
ramified tree, the trunk formed by the aorta (4, Blood 
Formation), and its many ramifications forming the 
branches. The arteries divide and subdivide, running 
into the most distant parts of the body, the larger 
arteries usually occupying the most protected situations. 
Generally the larger arterial branches pursue a perfectly 
straight course, but in certain places and situations they 
are very tortuous ; thus the facial artery, in its course over 
the face, the internal carotid, and the vertebral arteries 
just before they enter the cavity of the skull, describe a 
series of curves which are evidently intended to diminish 
the velocity of the current of blood by increasing the 
extent of surface over which it moves. 

THE PULMONARY ARTERY. 

(B, plate of Lungs; also 5, Blood Formation.) 

The pulmonary artery conveys the impure blood from the 
right side of the heart to the lungs. It is a short, wide vessel 
about two inches in length, and rises from the left side 
of the base of the right ventricle (27, Blood Formation) in 
front of the aorta. It ascends upward, backward and to 
the left side, and winds spirally in front of and then to the 
left of the c cending part of the arch of the aorta (4, Blood 
Formation) as far as the under surface of the transverse 
portion of the arch, where it divides into two branches of 
nearly equal size — the right and left pulmonary arteries. 

The right pulmonary artery (5, Blood Formation) is 
longer and larger than the left, runs outward behind the 


130 


ascending aorta and superior vena cava (i 3, Blood For¬ 
mation) to the root of the right lung, when it divides into 
two branches. The left pulmonary artery (5, Blood For¬ 
mation) passes in front of the descending aorta. 

THE AORTA. 

(See Blood Formation in Aid.) 

The aorta (4) is the main trunk of a series of vessels, 
which, arising from the heart, convey the red oxygenated 
blood to every part of the body for its nutrition. This 
vessel commences at the upper part of the left ventricle, 
and, after ascending for a short distance, arches backward 
and to the leftside over the root of the left lung, descends 
within the thorax, passes through the aortic opening in the 
diaphragm, and enters the abdominal cavity, terminating 
opposite the fourth lumbar vertebra (12, Skeleton plate), 
there dividing into the right and left common iliac arteries 
(F, back plate Body). 

The portion of the aorta situated in the thorax is called 
the thoracic aorta (6, Blood Formation), and, after passing 
through the diaphragm and entering the abdomen, it is 
called the abdominal aorta (10, Blood Formation). The 
aorta, and more especially its arch, is frequently the seat 
of disease, aneurisms often occurring at this point. 

The branches given off from the arch of the aorta are 
five in number, the right and left coronary , the innominate 
(2, Blood Formation), the left common carotid (1, Blood 
Formation), and the left subclavian (3, Blood Formation). 
The coronary arteries (Heart plate) supply the heart, and 
arise near the commencement of the aorta, just above the 
free margin of the semilunar valves (Heart plate). The 
right coronary artery, about the size of a quill, rises from 


the aorta immediately above the right semilunar valve, 
between the pulmonary artery (B, Heart plate) and the 
right auricular appendix (b, Heart plate). It passes 
through the right side in the groove between the right 
auricle and ventricle, and, curving around the right border 
of the heart, runs along its posterior surface as far as the 
posterior interventricular groove. It then divides into 
two branches, one of which continues in the groove 
between the left auricle and ventricle, and anastomoses 
with the left coronary; the other descends along the pos¬ 
terior interventricular furrow, and supplies branches to 
both ventricles and to the septum. The left coronary 
artery is larger than the right, rises immediately above 
the free edge of the left semilunar valve, a little higher 
than the right, passes between the pulmonary artery 
(B, Lung plate) and the left appendix auriculae (d, Heart 
plate), and descends toward the anterior interventricular 
groove, where it divides into two branches. One branch 
passes transversely outward in the left ventricular 
groove, and winds around the left border of the heart to 
its posterior surface; the other descends along the 
anterior interventricular groove to the apex of the heart, 
where it anastomoses with the descending branches of the 
right coronary artery. The left coronary artery supplies 
the left auricle and its appendix, both ventricles, and a 
number of small branches to the pulmonary artery and 
the commencement of the aorta. 

The innominate artery (2, Blood Formation) is the 
largest branch given off from the arch of the aorta. It rises 
from the commencement of the transverse portion in front 
of the left carotid artery (1, Blood Formation), ascends 
to the upper border of the right sterno-clavicular 
articulation, and divides into the right common carotid 


i3 2 


(i, Blood Formation) and subclavian arteries (3, Blood 
Formation). Of the common carotid arteries, the 
right rises from the arteria innominata behind the right 
sterno-clavicular articulation; the left, placed more deeply 
in the thorax, ascends outward from the arch of the aorta 
to the root of the neck. In front it is separated from the 
first piece of the sternum by the sterno-hyoid and the 
sterno-thyroid muscles, and the left innominate vein (14, 
Blood Formation). In the neck, the two common carotids 
resemble each other so closely that one description will 
answer for both. Each vessel passes upward from behind 
thesterno-clavicular articulation (9, plate of Ribs-Thorax) 
to a level with the upper border of the thyroid cartilage 
(d, plate of Muscles), where it divides into the external 
and the internal carotid arteries. 

The course of the common carotid is direct from the 
sternal end of the clavicle (f, Muscles) to the mastoid 
process above; this point is indicated by the lower lobe of 
the ear. At the lower part of the neck, the common 
carotid artery is very deeply seated, being covered by the 
superficial fascia, platysma, deep fascia, the sterno- 
mastoid (18, Muscles), sterno-hyoid (19, Muscles) and 
sterno-thyroid (d, Muscles) muscles. Inthe upper partof 
its course, near where it terminates, it is quite superficial. 
The external carotid artery (19, Head plate) commences 
opposite the upper border of the thyroid cartilage (d, mus¬ 
cles), takes a slight curved course, runs upward and for¬ 
ward, then inclines backward, and then divides into the 
temporal (18, Head plate) and internal maxillary 
arteries (35 and 23, Head plate). The facial artery (20, 
Head plate) arises a little above the lingual, and runs for¬ 
ward and upward beneath the lower jaw, then curves 
upward over the body of the jaw, runs forward and upward, 


133 


and crosses the cheek to the angle of the mouth, passes 
up alongside of the nose, and, under the name of the 
angular artery, terminates at the inner canthus of the eye. 
The facial artery, both in the neck and on the face, is very 
tortuous and very superficial; its pulsations may be dis¬ 
tinctly felt by slight compression against the bone. In 
its course over the face, it is covered by the fat of the 
cheek and is accompanied by the facial vein (17, Head 
plate) throughout its entire course, though the vein is not 
so tortuous as the artery. The anastomoses of the artery 
are very numerous. 

The occipital artery (3, Head plate) arises from the pos¬ 
terior part of the external carotid, opposite the facial. 
At its origin, it is covered by the posterior belly of the 
digastric and stylo-hyoid muscles, and part of the parotid 
gland; higher up it crosses the internal carotid artery and 
the internal jugular vein, then ascends to the interval 
between the transverse process of the atlas, and the mas¬ 
toid process of the temporal bone, then changes its course 
and passes vertically upward. The temporal artery (7 
a, Incision plate) is the smaller of the two terminal 
branches of the external carotid artery, and appears, from 
its direction, to be the continuation of that vessel. It 
divides into two branches, an anterior and a posterior. 

The anterior temporal inclines forward over the fore¬ 
head and anastomoses with the supraorbital and frontal 
arteries; the posterior temporal is larger, curves upward 
and backward along the side of the head, and inosculates 
with its fellow of the opposite side and with the posterior 
auricular and occipital arteries (3, Head plate). 

The internal maxillary (35, Head plate) is the largest of 
the terminal branches of the external carotid artery, passes 
inward at right angles from that vessel to the inner side 


134 


of the neck, and supplies the deep structures of the face. 
The internal carotid artery commences at the bifurcation 
of the common carotid artery, opposite the upper border 
of the thyroid cartilage, and runs perpendicularly upward 
in front of the transverse processes of the three upper 
cervical vertebrae, to the carotid foramen in the petrous 
portion of the temporal bone; after ascending for a short 
distance, it passes forward and inward through the carotid 
canal and enters the skull. 

The internal carotid artery supplies the anterior part 
of the brain, the eye, and its appendages, and sends 
branches to the forehead and the nose, its size in the adult 
equaling that of the external carotid. Its course is curved, 
thus diminishing the velocity of the current of blood by 
increasing the extent of surface over which it moves. It 
is divided into four portions, the cervical, the petrous, 
the cavernous , and the cerebral. 

The cervical portion is superficial at its commence¬ 
ment, being contained in the superior carotid triangle, and 
lying on the same level as the external carotid; but back 
of that artery it passes beneath the parotid gland, and is 
crossed by the external carotid and occipital arteries. 
When the internal carotid artery enters the canal in the 
petrous portion of the temporal bone, it first ascends a 
short distance, then curves inward, and again ascends as it 
leaves the canal to enter the skull cavity. The cavernous 
portion at first ascends to the posterior clinoid process, 
then passes forward by the side of the body of the sphenoid 
bone. The cerebral portion of the artery is on the outer 
side of the optic nerve. 

The ophthalmic artery rises from the internal carotid 
artery just as that vessel is emerging from the cavernous 
sinus on the inner side of the anterior clinoid process, and 





PRACTICAL ANATOMY FOR THE EMBALMER. 


A Few of the Parts from a Human Subject in twenty Dissections, showing 
the exact positions of the Arteries, Veins, Nerves and Muscles throughout the human 
body, also the organs of the Thoracic and Abdominal Cavities in their normal places. 


Cepha tic V. 
Braehia/i5 Ant/cusM. 


Extern3I Intermuscular 
hep rum. 

Outer tied,do,f TricepsM. 

Muscu/o spiralAt 

Superior ProfundaA. 


long Head of Triceps M. 



Vena comes 
Brachiat A. 
fn terna/Cutaneous ft 
Bast tic It 
Ulnar ft. 

tnfer/or Profunda A 


B/ceps m 


Superficial fascia 

fascia 
Median ft. 


TRANSVERSE SECTION IN “MIDDLE THIRD'' OF ARM WHERE THE 

BRACHIAL ARTERY IS USUALLY RAISED. 


Copyright, 1903, by H. S. Eckels & Co. 





























enters the orbit through the optic foramen. The frontal 
artery (Forehead), one of the terminal branches of the 
ophthalmic, passes from the orbit at its inner angle, and, 
ascending on the forehead, supplies the muscles, and 
anastomoses with the supraorbital artery (Eye). The nasal 
artery, the other terminal branch of the ophthalmic artery, 
emerges from the orbit above the tendo oculi, and divides 
into two branches, one of which anastomoses with the 
angular artery; the other runs along the dorsum of the 
nose, supplies its entire surface, and anastomoses with the 
artery of the other side. 

The cerebral branches of the internal carotid arc, the 
anterior cerebral , the middle cerebral , the posterior com¬ 
municating , and the anterior choroid. The anterior cere¬ 
bral (Head plate) rises from the internal carotid at the 
inner extremity of the fissure of Sylvius, passes forward 
between the two anterior lobes of the brain, soon after its 
origin being connected with the vessel of the opposite side 
by a short anastomosing trunk about one inch in length. 
The anterior communicating artery (Head plates) is a short 
branch about one inch in length, but of moderate size, 
connecting the two anterior cerebral arteries. Across the 
longitudinal fissure, the two arteries join to form a single 
front, which afterward subdivides, or the vessel may be 
wholly or partially subdivided into two portions. The 
middle cerebral is the largest branch of the internal 
carotid, passes outward along the fissure of Sylvius, 
where it divides into three branches: an anterior, which 
supplies the pia mater; a posterior, which supplies the mid¬ 
dle lobe; and a median branch, which supplies the small 
lobe at the outer extremity of the Sylvian fissure. The 
posterior communicating artery arises from the back part 
of the internal carotid, runs directly backward and anas- 


136 


tomoses with the posterior cerebral, a branch of the 
basilar. This artery varies considerably in size, occasion¬ 
ally being so large that the posterior cerebral may be con¬ 
sidered as arising from the internal carotid, rather than 
from the basilar. 

The anterior choroid (Head plate) is a small but 
constant branch which rises from the back part of the in¬ 
ternal carotid near the posterior communicating artery; 
passing backward and outward, it enters the descending 
horn of the lateral ventricle, beneath the edge of the middle 
lobe of the brain 

THE BLOOD-VESSELS OF TIIE BRAIN. 

The arteries of the brain are derived from the internal 
carotid and the vertebral arteries. On the left side, these 
vessels rise at such an angle that the blood current is much 
more direct than on the right ; thus accounting for the 
larger size and development of the left hemisphere. At 
the base of the brain, these four vessels form the circle of 
Willis. This circle consists of two sets of vessels, the 
anterior or carotid set, from which arise the anterior and 
middle cerebral arteries (Head plate), and the posterior or 
vertebral set, consisting of the basilar and posterior cere¬ 
bral arteries. Each set has a free anastomosis from side 
to side. 

ARTERIES OF THE UPPER EXTREMITY. 

(See plates in Aid.) 

The artery which supplies the upper extremity continues 
as a single trunk from its commencement down to the 
elbow ; but different portions of it have received different 
names according to the region through which it passes. 
That part of the vessel which extends from its origin to 


*37 


the lower border of the first rib is termed the subclavian 
artery (3, Blood Formation). Beyond this point to the 
lower border of the axilla it is termed the axillary artery 
(A, plate 4, Upper Extremity), and from the lower margin 
of the axillary space to the bend of the elbow it is termed 
the brachial artery (A, plate 2, Upper Extremity). At this 
point the single trunk terminates by dividing into two 
branches, the radial (B, plate 2, Upper Extremity), and the 
ulnar (G, plate 2, Upper Extremity), an arrangement pre¬ 
cisely similar to that occurring in the lower limb. 

The subclavian artery (3, Blood Formation) on the 
right side arises from the arteria innominata (2, Blood For¬ 
mation) opposite the rightsterno -clavicular articulation, and 
on the left from the arch of the aorta (4, Blood Formation); 
therefore these two vessels in the first part of their course 
differ in their length, their direction, and their relation 
with neighboring parts. The right subclavian artery (3, 
plate, Blood Formation) (4a, Incision plate) arises from 
the arteria innominata (1, Blood Formation) opposite the 
right sterno-clavicular articulation, passes upward across 
the root of the neck, and terminates at the inner margin 
of the scalenus anticus muscle, and in this part of its course 
ascends a little above the clavicle (5, Rib plate), the extent 
to which it does so varying in different cases. It is 
crossed by the internal jugular (16, Blood Formation) and 
vertebral veins. The left subclavian artery (3, Blood For¬ 
mation) arises from the end of the transverse portion of 
the arch of the aorta (4, Blood Formation), ascends to the 
inner margin of the first rib, is longer than the right, 
situated more deeply in the cavity of the chest, and 
directed almost vertically upward, instead of arching out¬ 
ward like the vessel of the opposite side. 

The vertebral artery (Blood Formation) is the first and 


largest branch of the subclavian, rises from the upper and 
back part of that vessel, passes upward and enters the 
foramen in the transverse process of the sixth cervical ver¬ 
tebra. It ascends through the foramina in the transverse 
processes of all the vertebrae above the sixth, and above 
the upper border of the axis it inclines upward to the 
foramen in the transverse process of the atlas, through 
which it passes. It enters the skull through the foramen 
magnum, then passes upward to the front of the medulla 
oblongata (45, Head plate), and unites with the vessel of 
the opposite side at the lower border of the pons Varolii 
to form the basilar artery. Within the skull it winds 
around the medulla oblongata. The basilar artery (Head 
plate), so named from its position at the base of the skull, 
is a single trunk formed by the two vertebral arteries. It 
extends from the posterior to the anterior border of the 
pons Varolii, and has several branches ; namely, the trans¬ 
verse , the anterior inferior cerebellar , superior cerebellar , 
and the posterior cerebral. The transverse branches sup¬ 
ply the pons Varolii and adjacent parts of the brain ; the 
superior cerebellar (Head plate) rises near the termination 
of the basilar, and, on arriving at the upper circle of the 
cerebellum, they divide into branches which ramify in the 
pia mater and anastomose with the inferior cerebellar; the 
posterior cerebral, the two terminal branches of the basi¬ 
lar, are larger than the preceding, anastomose with the 
anterior and middle cerebral artery, and near their origin 
receive the posterior communicating arteries from the 
internal carotid, and give off numerous branches which 
enter the posterior perforated space. The remarkable 
anastomoses which exist between the branches of the inter¬ 
nal carotid and vertebral arteries at the base of the brain, 
constitute the circle of Willis. This circle is formed in 


139 


front by the anterior cerebral arteries, and branches of the 
internal carotid, which are connected together by the ante¬ 
rior communicating artery ; behind by the two posterior 
cerebral branches of the basilar, which are connected through 
the internal carotid by the posterior communicating artery. 
It is by this anastomosis that the cerebral circulation is 
equalized and provision made for effectually carrying it on 
if any of the branches should be damaged or obliterated. 
The internal mammary artery (Breast) arises from the 
under surface of the first portion of the subclavian artery, 
descends behind the clavicle to the inner surface of the 
chest, rests against the costal cartilages a short distance 
from the margin of the sternum, and divides into two 
branches. 

The axillary artery (A, plate 4, Upper Extremity), the 
continuation of the subclavian, commences at the lower 
border of the first rib, and terminates at the lower border 
of the tendon of the teres major muscle, where it takes the 
name of the brachial (B, plate 4, Upper Extremity). Its 
direction varies with the position of the limb, as, when the 
arm lies by the side of the chest, the vessel forms a gentle 
curve, the convexity being upward; when the limb is 
directed at right angles with the trunk, the vessel is 
nearly straight; when elevated, it describes a curve. At 
its commencement, the artery is very deeply situated, but 
near its termination is quite superficial, being covered 
only by the skin and fascia. The subscapular (plate 4, 
Upper Extremity) is the largest branch of the axillary 
artery, arises opposite the lower border of the subscapu- 
laris muscle, and passes downward. The posterior and 
anterior circumflex arteries wind around the neck of the 
humerus; the posterior circumflex (1, plate 4, Upper Ex¬ 
tremity) is the larger of the two, rises from the back part 
3 


of the axilla, and, passing backward with the circumflex 
veins, anastomoses with the anterior circumflex (A, plate 
4, Upper Extremity) and thoracic arteries, and with the 
superior profunda branch (L, plate 4, Upper Extremity) of 
the brachial artery; the anterior (H, plate 4 , Upper Ex¬ 
tremity) arises just below that vessel from the outer side 
of the axillary artery. 

The brachial artery (B, plate 4, Upper Extremity) 
commences at the lower margin of the tendon of the teres 
major, and, passing down the inner and anterior aspect of 
the arm, terminates about one-half inch below the elbow, 
where it divides into the radial (B, plate 2, Upper Extrem¬ 
ity) and ulnar arteries (G, plate 2, Upper Extremity). Like 
the axillary, the direction of the brachial artery varies 
with the position and situation of the arm; if the arm be 
directed downward by the side of the body, the artery 
takes a spiral course, and is much deeper seated; but, if 
the arm is held in a horizontal position or directly out¬ 
ward with the palmar suface of the hand upward, its 
course is almost on a straight line and nearer the surface, 
making it more superficial, and decidedly easier for the 
operator to reach. When about to take up the brachial 
artery for an injective point, turn the hand with the palm 
upward, as this will bring the artery to the desired posi¬ 
tion. In the upper part of the arm, the artery lies inter¬ 
nal to the bone; but below it is in front, lying between 
the border of the biceps and triceps muscles, which make 
a good landmark; it is always accompanied by two com¬ 
panion veins, the venae comites (5, plate 2, Upper Extrem¬ 
ity), and the nerve of the arm. These are sometimes found 
in one sheath, and can be separated very easily. For the 
purpose of injecting, the brachial artery is frequently used 
by embalmers, as it is easily found, and affords the op¬ 
erator a chance to hide or cover up his work, which in 


some cases is very important. In embalming a child, 
however, the brachial artery would practically be useless, 
as its caliber is so small. With children it is advisable to 
use the carotid or the femoral artery, preferably the former 
as there is no danger of injury or of discoloration. Give 
the tubing a downward course, and naturally the fluids dis¬ 
tribute to the body first, the upoei extremities receiv¬ 
ing the injection more slowly, as the branches take off 
the recurring current. Afterwards inject a few ounces 
of fluid up towards the head, being careful not to use 
more than necessary. In raising the brachial artery for 
embalming purposes, it is well to make incision about two 
inches below the axilla, as in that position the small 
branches can be avoided and considerable leakage be pre¬ 
vented. The radial artery (B, plate 2, Upper Extremity), 
though smaller, appears from its direction to be the con¬ 
tinuation of the brachial artery. It commences at the 
bifurcation of the brachial, just below the bend of the 
elbow, and passes along the radial side of the forearm to 
the wrist, then winds backward around the outer side of 
the wrist beneath the extensor tendons of the thumb, and 
finally passes forward between the two heads of the first 
dorsal interosseous muscle into the palm of the hand, 
where it crosses the metacarpal bones to the ulnar border 
of the hand to form the deep palmar arch (G, plate 2, 
Upper Extremity). At its termination it inosculates with 
the deep branch of the ulnar artery. 

The radial artery is accompanied by the radial nerve (i, 
last plate, Upper Extremity), lying on the radial side of 
the radial artery, and by its two companion veins, the 
venae comites. If occasion should require, the radial 
artery maybe used for injecting purposes, sometimes with 
very good results ; but, as it is smaller than the ulnar, and 
exposed to view at the wrist, where it is quite superficial, 


142 


this is not advisable where a larger and more convenient 
artery is available. The operation, also, would neces¬ 
sarily be very slow. 

The ulnar artery (G, plate 2, Upper Extremity), the 
larger of the two subdivisions of the brachial, commences 
a little below the bend of the elbow, and crosses the inner 
side of the forearm obliquely inward to the commencement 
of its lower half; it then runs along its ulnar border to the 
wrist, crosses the annular ligament on the radial side of 
the pisiform bone, and passes across the palm of the hand, 
forming the superficial palmar arch. This arch describes 
a curve with its convexity to the fingers and to the space 
between the ball of the thumb and the index finger, where 
it anastomoses with a branch from the radialis indicis, thus 
completing the arch. If the thumb be placed at right 
angles to the hand, its position will be indicated by a line 
drawn along the lower margin of the thumb, across the 
palm. It is covered by the palmar fascia, the palmaris 
brevis and integument. The deep palmar arch is situated 
about one finger’s breadth nearer the carpus. The ulnar 
nerve (K, plate 3, Upper Extremity) accompanies the 
artery (E, plate 3, Upper Extremity) a short part of its 
course. The ulnar artery gives off ten branches, of which 
those in the forearm are called the anterior ulnar recurrent 
(G, lower part plate 4, Upper Extremity), the posterior 
ulnar recurrent , the interosseous (H. lower part plate 4, 
Upper Extremity), the anterior interosseous , th z posterior 
interosseous , and the muscular ; those in the wrist are the 
anterior carpal and the posterior carpal; those in the hand 
are the deep or communicating branch and the digital. 

The anterior ulnar recurrent branch rises immediatelv 

* 

below the elbow joint, passes inward, and supplies the 
brachialis anticus and pronator radii teres muscles; the 


posterior ulnar recurrent branch is much larger, and, rising 
a little lower, passes backward and inward beneath the 
flexor sublimis, and ascends behind the inner condyle of 
the humerus, supplying the neighboring joints and muscles, 
and anastomosing with the inferior profunda and interos¬ 
seous recurrent arteries. The interosseous artery (H, lower 
part Upper Extremity, plate 4) is a short trunk about 
one inch in length, and of considerable size. It rises 
immediately below the tuberosity of the radius, and divides 
into two branches, the anterior and posterior interosseous. 
The anterior interosseous artery passes down the forearm 
on the anterior surface of the interosseous membrane, 
accompanied by the interosseous branch of the median 
nerve, then down behind the pronator quadratus, and 
anastomoses with the posterior interosseous artery. The 
posterior interosseous artery passes backward through the 
interval between the oblique ligament and the upper 
border of the interosseous membrane; descending to the 
wrist, it anastomoses with the termination of the anterior 
interosseous, and with the posterior carpal branches of the 
radial and ulnar arteries. Near its origin it gives off the 
interosseous recurrent branch. The muscular branches are 
distributed through the muscles along the ulnar side of the 
forearm. The carpal branches (1, plate 4,Upper Extremity) 
supply the wrist joint. Of these, the anterior carpal is a 
small vessel which crosses the front of the carpus and inos¬ 
culates with a corresponding branch of the radial artery; 
the posterior carpal arises immediately above the pisiform 
bone, and winds backward beneath the tendon of the flexor 
carpi ulnaris. It anastomoses with a corresponding 
branch of the radial artery, and, forming the posterior 
carpal arch immediately after its origin, it gives off a small 
branch which runs along the ulnar side of the metacarpal 


144 


bone of the little finger, forming one of the metacarpal 
arteries and supplying the ulnar side of the dorsal surface 
of the little finger. The deep or communicating branch 
arises at the commencement of the palmar arch, anas¬ 
tomoses with the termination of the radial artery, and 
thus completes the deep palmar arch. The digital 
branches (lower part plate 5, Upper Extremity) are four 
in number, and are given off from the convexity of 
the superficial palmar arch. They supply the ulnar 
side of the little finger, and the adjoining sides of the four 
fingers, the radial side of the index finger and thumb 
being supplied from the radial artery. The digital arteries 
are at first superficial; but, as they pass forward to the 
clefts between the fingers, they lie between them, and are 
there joined by the interosseous branches from the deep 
palmar arch. The digital arteries on the sides of the 
fingers lie beneath the digital nerves, and, about the 
middle of the last phalanx, the two branches for each 
finger form an arch. 

The descending aorta (4, Blood Formation) is divided 
into two portions, the thoracic (6, Blood Formation) and 
the abdominal aorta (a, back plate Body), in correspond¬ 
ence with the two great cavities of the trunk, in which it is 
situated. The thoracic aorta (6, Blood Formation) com¬ 
mences at the lower border of the fifth dorsal vertebra 
on the left side, and terminates at the aortic opening in 
the diaphragm, in front of the last dorsal vertebra. At 
its commencement, it is situated on the left side of the 
spine, approaches the median line as it descends, and at 
its termination lies directly in front of the column. As its 
branches are small, the diminution in the size of the ves¬ 
sel is inconsiderable. In front it is in relation from above 
downward with the left pulmonary artery (5, Blood Forma- 


145 


tion), behind with the vertebral column and the vena 
azygos minor, on the right side with the vena azygos major 
and the thoracic duct (29, Blood Formation), on the left 
side with the pleura and lung. 

The branches of the thoracic aorta (6, Blood Forma¬ 
tion) are the pericardiac , the bronchial, the (esophageal , 
the posterior mediastinal , and the intercostal. The peri¬ 
cardiac arteries are a few small vessels irregular in their 
origin and distributed to the pericardium. The bronchial 
arteries are the nutrient vessels of the lungs, and vary in 
number, size and origin; that of the right side rises from 
the first aortic intercostal, or by a common trunk with the 
left bronchial, from the front of the thoracic aorta; those of 
the left side, usually two in number, rise from the thoracic 
aorta, one a little lower than the other. The oesophageal 
arteries, usually five in number, rise from the front of the 
aorta, and pass downward to the oesophagus, anastomosing 
with the oesophageal branches of the inferior thyroid arteries 
above, and with ascending branches from the phrenic and 
gastric arteries below. The posterior mediastinal arteries 
are many but small vessels which supply the glands and 
loose areolar tissue in the mediastinum. The intercostal 
arteries, of which there are usually ten pairs, rise from 
the back part of the aorta, and lie on each side of the 
superior intercostal space. The right arteries are longer 
than the left, and, on account of the position of the aorta 
on the left side of the spine, they pass outward across the 
bodies of the vertebrae to the intercostal spaces, being 
covered by the pleura, the oesophagus, the thoracic duct 
and vena azygos major. The left pass beneath the supe¬ 
rior intercostal vein, the azygos vein, the vena azygos 
minor and sympathetic. In the intercostal spaces, each 
artery divides into two branches, an anterior and a poste- 


146 


rior branch. The anterior branch passes outward, then 
between the two layers of intercostal muscles, and, having 
ascended to the lower border of the rib above, divides near 
the angle of that bone into two branches. Of these, the 
larger runs in the groove on the lower border of the rib 
above; the smaller, along the upper border of the rib below. 
As they pass forward, they supply the intercostal muscles, 
and anastomose with the anterior intercostal branches of 
the internal mammary and with the thoracic branches of 
the axillary artery. The first aortic intercostal artery 
anastomoses with the superior intercostal, and the last 
three pass between the abdominal muscles, inosculating 
with the epigastric in front, and with the lumbar arteries. 
Each intercostal artery is accompanied by a vein and 
nerve, the former above, the latter below, and are pro¬ 
tected from pressure during the action of the intercostal 
muscles bv fibrous arches thrown across and attached bv 

* 4 

each extremity to the bone. The posterior branch of 
each intercostal artery passes backward to the inner side 
of the anterior costo-transverse ligament, and divides into 
a spinal branch, which supplies the vertebrae, the spinal 
cord and its membranes. 

The abdominal aorta (A, last plate Body) commences at 
the aortic opening of the diaphragm in front of the body 
of the last dorsal vertebra, and, descending a little to the 
left side of the vertebral column, terminates on the body 
of the fourth lumbar vertebra, generally to the left of the 
median line, where it divides into the two common iliac 
arteries (F, last plate Body). It diminishes in size very 
rapidly in consequence of the many large branches which 
it gives off. It is covered in front by the stomach, behind 
which are the branches of the coeliac axis and the solar 
plexus, and below these by the splenic vein (21, Blood 


T 47 


Formation), the pancreas (19, last plate Body), the left 
renal vein (W, last plate Body), the transverse portion of 
the duodenum, the mesentery and the aortic plexus. Be¬ 
hind, it is separated from the lumbar vertebra by the left 
lumbar veins (A, last plate Body) and thoracic duct (29, 
Blood Formation). On the right side it is in relation 
with the inferior vena cava (E, last plate Body); on the 
left with the sympathetic nerve and left semilunar gan¬ 
glion. The single branches of the abdominal aorta (A, last 
plate Body) are the coeliac axis (7, Blood Formation), the 
superior mesenteric and the inferior mesenteric (Y, last 
plate Body). 

The cceliac axis (see Blood Formation) is a short, thick 
trunk about one-half inch in length, which arises from 
the aorta opposite the margin of the diaphragm, and, pass¬ 
ing horizontally forward, divides into three large arteries— • 
the gastric (7), the hepatic (8), and the splenic (9), and 
occasionally giving off one of the phrenic arteries. It is 
covered by the lesser omentum on the right side, is in 
relation with the right semilunar ganglion and the lobus 
Spigelii ; on the left side with the left semilunar ganglion 
and cardiac end of the stomach, and below rests on the 
upper border of the pancreas. The gastric artery (7, 
Blood Formation), the smallest of the three branches of 
the coeliac axis, passes up and to the left side to the car¬ 
diac orifice of the stomach, distributing branches to the 
oesophagus, which anastomose with the aortic oesophageal 
arteries, and others which supply the cardiac end of the 
stomach, inosculating with branches of the splenic artery. 

It then passes from left to right along the lesser curvature 
of the stomach to the pylorus, and at its termination anas¬ 
tomoses with the pyloric branch of the hepatic artery. 
The hepatic artery (8, Blood Formation) is intermediate 


148 


in size between the gastric and splenic arteries. It is first 
directed forward and to the right, to the upper margin of 
the pyloric orifice of the stomach, forming the lower 
boundary of the foramen of Winslow, then passes upward 
between the layers of the lesser omentum and in front 
of the foramen of Winslow to the transverse fissure of the 
liver, where it divides into two branches — right and left — 
which supply the corresponding lobes of that organ. 
This artery, in its course along the right border of the 
lesser omentum, is in relation with the portal veins. The 
cystic artery, a branch of the hepatic, passes upward 
along the neck of the gall-bladder, and divides into two 
branches, one of which ramifies on its free surface, the 
other between it and the substance of the liver. The 
splenic artery (9, Blood Formation) is the largest of the 
three branches of the coeliac axis, and is very tortuous in 
its course. Accompanied by the splenic vein, which lies 
below, it passes along the left side of the upper border of 
the pancreas, and, on arriving near the spleen, divides into 
branches, some of which are distributed to the great end 
of the stomach, and others, the pancreatic, to the pan¬ 
creas. 

The superior mesenteric artery (11, Blood Formation) 
supplies, with the exception of the first part of the 
duodenum, the whole length of the small intestine, the 
caecum, and ascending and transverse colon. It is a very 
large vessel arising from the fore part of the aorta about 
one-fourth inch below thecceliac axis, being covered at its 
origin by the splenic vein (21, Blood Formation) and 
pancreas. It passes forward between the transverse por¬ 
tion of the pancreas and duodenum, crosses in front of 
this portion of the intestine, and descends between the 
layers of the mesentery to the right iliac fossa, where, 


diminished in size, it terminates. In its course it forms 
an arch, is accompanied by the superior mesenteric vein 
and has five branches. The inferior pancreatico-duodenal 
branch is given off behind the pancreas, and anastomoses 
with the superior pancreatico-duodenal artery; the ileo¬ 
colic is the lowest branch given off from the concavity of 
the artery; the colica dextra branch arises from about the 
middle of the concavity of the artery, and, passing beneath 
the peritoneum to the middle of the ascending colon, 
divides into two branches, one descending and one ascend¬ 
ing; the colica media branch arises from the upper part 
of the concavity of the artery, and, passing forward between 
the layers of the transverse meso-colon, divides into two 
branches — the one on the right side inosculating with 
the colica dextra, and that on the left with the colica 
sinistra, a branch of the inferior mesenteric. 

The inferior mesenteric artery (V, last plate Body) sup¬ 
plies the descending and sigmoid flexure of the colon (14, 
Stomach plate) and the greater part of the rectum. It is 
smaller than the superior mesenteric, and arises from the 
left side of the aorta between one and two inches above 
its division into the common iliacs, passes downward to 
the left iliac fossa, and then descends, under the name of 
the superior haemorrhoidal arteries, between the layers of 
the meso-rectum into the pelvis. It lies at first in close 
relation with the left side of the aorta, and then passes, as 
the superior haemorrhoidal artery, in front of the. ? eft com¬ 
mon iliac artery, dividing into the colica sinistra, sigmoid 
and superior licemorrhoidal branches. Of these the colica 
sinistra passes behind the peritoneum in front of the left 
kidney to reach the descending colon, and divides into an 
ascending and descending branch; the sigmoid artery runs 
downward across the psoas muscle to the sigmoid flexure 


of the colon, and divides into branches which supply that 
part of the intestine, anastomosing above with the colica 
sinistra, and below with the superior haemorrhoidal 
branches; the superior haemorrhoidal ascends into tht 
pelvis, crossing in its course the ureter and left common 
iliac vessels, dividing, opposite the middle of the sacrum, 
into two branches, which descend one on each side of the 
rectum, where they divide into several small branches, which 
are distributed between the mucous and muscular coats 
of that tube nearly as far as its lower end, anastomosing 
with each other, with the middle haemorrhoidal artery, 
and branches of the internal iliac artery. 

The supra-renal arteries are two small vessels rising one 
on each side of the aorta, opposite the superior mesenteric 
artery, and passing upward to the under surface of the 
supra-renal capsules, to which they are distributed. They 
anastomose with capsular branches from the phrenic and 
renal arteries, and in the adult are of small size. 

The renal arteries (V, last plate Body) are two large 
trunks which rise from the sides of the aorta immediately 
below the superior mesenteric artery, each directed out¬ 
ward so as to form nearly a right angle with that vessel. 
Previous to entering the kidney, each artery divides into 
four or five branches which are distributed to its sub¬ 
stance. 

The spermatic arteries (X, last plate Body) distributed 
to the testes in the male, and the ovaria in the female, are 
two slender vessels of considerable length which arise from 
the front of the aorta just below the renal arteries. On 
reaching the margin of the pelvis (22, last plate Body) each 
vessel passes in front of the corresponding iliac artery, in 
the male being directed outward to the internal abdominal 
ring, and accompanying the other constituents of the sper- 


T 5 T 

malic cord (i 8 ,Male Genital Organs), along the spermatic 
canal to the testes (20, Male Genital Organs), where it 
divides into several branches. In the female, the sper¬ 
matic arteries (X, last plate Body) are shorter than in the 
male, and do not pass out of the abdominal cavity, but, on 
arriving at the margin of the pelvis (22, last plate Body), 
each artery passes inward between the two laminae of the 
broad ligament of the uterus (U, Female Genital Organs) 
to be distributed to the ovary (O, Female Genital Organs), 
one or two small branches supplying the Fallopian tube 
(F, 1 , Female Genital Organs), another passing on to the 
side of the uterus and anastomosing with the uterine 
arteries. 

The phrenic arteries are two small vessels which present 
a great deal of variety in their origin. They may arise 
separately from the front of the aorta immediately above 
the cceliac axis, or by a common trunk which may spring 
from the aorta or from the coeliac axis, or sometimes one 
is derived from the aorta and the other from one of the 
renal arteries. They diverge from one another across the 
crura of the diaphragm, and then pass obliquely upward 
and outward upon its under surface, the left passing 
behind the oesophagus, and running forward on the left side 
of the oesophageal opening, the right passing behind the 
interior vena cava, and ascending along the right side of 
the aperture for transmitting that vein. 

Near the back part of the central tendon each vessel 
divides into two branches, the internal branch running for¬ 
ward to the front of the thorax, supplying the diaphragm, 
and anastomosing with its fellow of the opposite side and 
with the musculo-phrenic branches of the internal mam¬ 
mary (Breast), the external branch passing the side of the 

thorax and inosculating with the intercostal arteries. The 

3 


*52 


internal branch of the right phrenic gives off a few vessels 
to the inferior vena cava, the left, some branches to the 
oesophagus, and each vessel sends capsular branches to the 
supra-renal capsule of its own side, the spleen and the liver. 

The lumbar arteries (V, last plate Body), usually four 
pairs, are analogous to the intercostal, and rise from the 
back of the aorta nearly at right angles with that vessel. 
They pass out and back around the sides of the body of 
the lumbar vertebrae, those on the right being covered by 
the inferior vena cava (E, last plate Body), and the two 
upper ones on each side by the crura of the diaphragm. 
In the interval between the transverse processes of the 
vertebrae, each artery divides into a dorsal and abdominal 
branch. The dorsal branch gives off, immediately after 
its origin, a spinal branch, which enters the spinal canal, 
continues on its course backward between the transverse 
processes, and is distributed to the muscles and integu¬ 
ment of the back, anastomosing with the similar branches 
of the adjacent lumbar arteries and with the intercostal 
branches. It also divides into twobranches, one of which 
ascends on the posterior surface of the body of the vertebrae 
above, and the other descends on the posterior surface of 
the vertebrae below. The inosculations of these vessels 
on each side throughout the whole length of the spine, 
form a series of arterial arches behind the bodies of the 
vertebrae, which are connected with each other and with 
a median longitudinal vessel. The abdominal branches 
pass outward behind the quadratus lumborum, the lowest 
branch occasionally in front of that vessel, and, being con¬ 
tinued between the abdominal muscles, anastomose with 
branches of the epigastric and internal mammary in front, 
the intercostals above, and those of the ilio-lumbar and cir¬ 
cumflex iliac below. 


153 


The middle sacral artery is a small vessel about the 
size of a common quill, which arises from the back of the 
aorta just at its bifurcation, descends at the last lumbar 
vertebra and along the middle line of the front of the 
sacrum to the upper part of the coccyx, where it anas¬ 
tomoses with the lateral sacral arteries, and terminates 
in a middle branch, which runs down to that portion 
of the body described as Luschka’s gland. Other 
branches are given off on each side which anastomose 
with the lateral sacral arteries. Luschka’s gland lies 
near the tip of the coccyx, just above the coccygeal 
attachment of the sphincter, and consists of a congeries of 
small arteries derived from the middle sacral and freely 
communicating with each other. 

The abdominal aorta divides into the two common iliac 
arteries ( G, last plate body), the bifurcations usually tak¬ 
ing place on the left side of the body of the fourth lumbar 
vertebra, a point corresponding to the left side of the 
umbilicus (white spot, last plate of Body), and on a level 
with a line drawn from the highest point of one iliac crest 
to the other. The common iliac arteries are about two 
inches in length, diverge from the termination of the 
aorta, pass downward and outward to the margin of the 
pelvis, and divide, opposite the intervertebral substance 
between the last lumbar vertebra and the sacrum, into 
two branches, the external and the internal iliac arteries, 
the former supplying the lower extremity, the latter the 
viscera, and parietes of the pelvis. The right common 
iliac is somewhat larger than the left, and passes more 
obliquely across the body of the last lumbar vertebra; in 
front of it are the peritoneum, the ilium, branches 
of the sympathetic nerve, and at its point of 
division, the ureter; while behind it is separated from 


I 54 


the last lumbar vertebra by the two common iliac veins, 
and on its outer side it is in relation with the interior vena 
cava, the right common iliac vein above, and the psoas 
magnus muscle below. The left common iliac is in relation 
in front with the peritoneum, branches of the sympa¬ 
thetic nerve, and the superior haemorrhoidal artery, and 
is crossed at its point of bifurcation by the ureter (24, 
last plate Body). The common iliac arteries give off small 
branches to the peritoneum, psoas magnus, ureters, and 
the surrounding cellular tissue, and occasionally give ori¬ 
gin to the renal arteries. The internal iliac artery sup¬ 
plies the walls and viscera of the pelvis (22, back plate 
Body), the generative organs, and the inner part of the 
thigh. It is a short, thick vessel, about an inch and a 
half in le ngth, rising at the point of bifurcation of the 
common iliac, passing downward to the upper margin of 
the great sacro-sciatic foramen, and dividing into two 
■arge trunks. The internal iliac has twelve branches, a 
few of which it is necessary to mention. These are the 
uterine artery, or the artery of the womb, the vaginal 
artery, and a few arteries common to both sexes. The 
uterine artery passes downward from the anterior trunk of 
the internal iliac to the neck of the uterus, ascending in a 
tortuous course on the side of the viscera; between the 
layers of the broad ligament it distributes branches to its 
substance, anastomosing near its termination with a branch 
from the ovarian artery, and branches from this vessel are 
also distributed to the bladder and ureter. The vaginal 

o 

artery is analogous to the inferior vesical in the male, 
descends upon the vagina, supplying its mucous membrane, 
and sends branches to the neck of the bladder and contig¬ 
uous parts of the rectum. 

The obturator artery (last plate Body) usually arises 


155 


from the anterior trunk of the internal iliac, passes forward 
below the brim of the pelvis to the canal in the upper 
border of the obturator foramen, and, escaping from the 
pelvic cavity through this aperture, divides into an internal 
and an external branch. In the pelvic cavity this vessel 
lies upon the pelvic fascia, beneath the peritoneum, and a 
little below the obturator nerve, and, while passing through 
the obturator foramen, is contained in a canal formed by 
the horizontal branch of the pubes above, and the border 
of the obturator membrane below. Within the pelvis, the 
obturator artery gives off a branch of the iliac to the 
iliac fossa, which anastomoses with the ilio-lumbar artery, 
a vesical branch, which supplies the bladder, and pubic 
branch, which is given off before it leaves the pelvic 
cavity. External to the pelvis, the obturator artery 
divides into an external and an internal branch, which are 
both deeply seated beneath the obturator externus muscle, 
and which anastomose at the lower part of this aperture 
with each other, and with branches of the internal circum¬ 
flex artery. The internal branch curves downward along 
the inner margin of the obturator foramen, distributes 
branches to three or four muscles, and anastomoses with 
the external branch and internal circumflex artery; the 
external branch curves around the outer margin of the 
foramen obturator to the space between the gemellus 
inferior and quadratus femoris, where it anastomoses with 
the sciatic artery, as it passes backward with the internal 
circumflex; it also sends a branch to the hip joint. 

The internal pudic is the smallest of the two terminal 
branches of the anterior trunk of the internal iliac, and 
supplies the external organs of generation ; it divides 
finally into two terminal branches, the dorsal artery of the 
penis and the artery of the corpus cavernosum. It is 

4 


accompanied by the pudic veins and nerve. Ihe dorsal 
artery of the penis ascends between the crus and pubic 
symphysis, runs forward on the dorsum of the penis to 
the elans, where it divides into two branches which sup- 
ply the glans and prepuce. On the dorsum of the penis 
it lies immediately beneath the integument parallel with 
the dorsal vein and the corresponding artery of the oppo¬ 
site side. 

The sciatic artery, the larger of the two terminal 
branches of the anterior trunk of the internal iliac, is dis¬ 
tributed to the muscles on the back of the pelvis, passes 
down to the lower parts of the great sacro-sciatic fora¬ 
men, behind the internal pudic, then descends in the 
interval between the trochanter major and the tuberosity 
of the ischium. 

The gluteal artery (B, last plate Body) is the largest 
branch of the internal iliac, and appears to be the contin¬ 
uation of the posterior division of that vessel. It is a 
short, thick trunk which passes out of the pelvis above 
the upper border of the pyriformis muscle, and immedi¬ 
ately divides into a superficial and deep branch ; just 
before it leaves the cavity of the pelvis it gives off a 
nutrient artery which enters the ilium. The superficial 
branch passes beneath the gluteus maximus and divides 
into many branches. The deep branch runs between the 
gluteus medius and minimus, and subdivides into the 
superior and inferior division ; the former continues the 
original course of the vessel, and anastomoses with the 
cimcumflex iliac and ascending branches of the external 
circumflex artery ; the latter crosses the gluteus minimus 
obliquely to the trochanter major, and inosculates with 
the circumflex artery. 

The external iliac artery is the chief vessel which sup- 




Trapezius M. 

LavaturAnguliScapulae M. 

Antdiv. dF 6th CervicalN. 

Vertebral A. and Veins 

6th Cervical Veriebra — 

Spinal Card 
Ligamentum Nuchae 


Cervical is Ascenders M. 
Transversalis Colli M. 
Splenius M. 

Superficial lager dF deep Fascia 
Complex us M. 

Semispinalis Colli M. 

Multi Fid us spinai M. 


TRANSVERSE SECTION OF THE NECK IN REGION WHERE THE 

CAROTID ARTERIES ARE RAISED. 

Copyright, 1903, by H. S. Eckels & Co. 


PRACTICAL ANATOMY FOR THE EMBALMER. 


A Few of the Parts from a Human Subject in twenty Dissections, showir 
the exact positions of the Arteries, Veins, Nerves and Muscles throughout the hums 
body, also the organs of the Thoracic and Abdominal Cavities in their normal place 


Super Final fascia- 
Superficial layer ofdeep fascia 

Trachea 

Sterna - hyoid M. - 
5ter no-thyroid M. 

Co mm on Carotid A. 

Internal Jugular V- 
fJmo-hyoid tendon 
AnteriorScalene M. 

Middle Scalene M. 

PosteriorScaleneM- 


Esophagus 

Thyroid body 
Anterior Jugular V. 

LongusColli M. 

Ld mmon Carotid A 
Pneumagastric A, 

Internal Jugular V. 

Superficial layer oFdeep Fascia 
Ant. Civ. oFSlh Cervical N. 

*mastoid M. 
External Jugular V. 








































































*57 


plies the lower limb. It is larger than the internal iliac, 
and passes downward and outward along the inner border 
of the psoas muscle from the bifurcation of the common 
iliac to Poupart’s ligament (31, Muscle plate), where it 
enters the thigh and becomes the femoral artery. At its 
origin it is crossed by the ureter, and numerous lymphatic 
vessels are found lying on its front and inner side. Besides 
several small branches, the external iliac gives off two 
branches of considerable size, the deep epigastric and deep 
c ire u mfiex il ia c . 

The deep epigastric artery arises from the external iliac 
a few lines above Poupart’s ligament, at first descends to 
reach this ligament, then ascends along the inner margin 
of the internal abdominal ring, and finally divides into 
numerous branches which anastomose above the umbilicus 
with the terminal branches of the internal mammary and 
inferior intercostal arteries. The deep circumflex artery 
rises from the outer side of the external iliac, nearly 
opposite the epigastric artery, ascends obliquely upward 
behind Poupart’s ligament, runs along the inner surface of 
the crest of the ilium to about its middle, where it pierces 
the transversalis, and runs backward between that muscle 
and the internal oblique to anastomose with the iliac, lumbar 
and gluteal arteries. Opposite the anterior superior spine 
of the ilium it gives off a large branch, which ascends 
between the internal oblique and transversalis muscle, sup¬ 
plying them, anastomosing with the lumbar and epigastric 
arteries. 

The femoral artery (A, plate 3, Lower Extremity), the 
continuation of the external iliac, commences immediately 
behind Poupart’s ligament, midway between the anterior 
superior spine of the ilium, and the symphysis pubis, and, 
passing down the fore part and inner side of the thigh, 


i,58 


terminates at the opening in the adductor magnus at the 
junction of the middle with the lower third of the thigh, 
where it becomes the popliteal artery. The upper two- 
thirds of a line drawn from a point midway between the 
anterior superior spine of the ilium and the spine of the 
pubis to the inner side of the inner condyle of the femur, 
with the thigh abducted and rotated so that the foot stands 
outward, will indicate the course of this artery. 

In the upper third of the thigh, the femoral artery is 
very superficial, and is contained in a triangular space 
called Scarpa’s triangle, which corresponds to the depres¬ 
sion seen immediately below the groin fold. The apex of 
the triangle is directed downward, the sides formed 
externally by the sartorius muscle, internally by the 
adductor longus, and above by Poupart’s ligament. The 
floor of this space is formed by the iliacus , psoas,pectineus , 
adductor longus , and a small part of the adductor brans 
muscle . It is divided into two nearly equal parts by the 
femoral vessels, which extend fiom the middle of its base to 
its apex. The artery in this situation gives off its cutaneous 
and profunda branches. The branches of the femoral 
artery are the superficial epigastric , superficial circumflex 
iliac , superficial external pudic, the deep external pudic , 
and the several profunda branches — namely the external 
circumflex , internal circumflex , and three perforating . 

The superior epigastric rises from the femoral about 
one-half an inch below Poupart’s ligament, and, passing 
through the saphenous opening in the fascia lata, ascends 
to the abdomen and anastomoses with branches of the 
deep epigastric and internal mammary arteries; the super¬ 
ficial circumflex iliac (D, back plate Body), the smallest 
of the cutaneous branches, rises close to the preceding 
branch, runs outward parallel with Poupart’s ligament as 


far as the crest of the ilium, and there divides into 
branches, supplying the fascia and the inguinal glands, 
and anastomosing with the circumflex iliac (B, back plate 
Body) and with the gluteal and external circumflex artery; 
the superficial external pudic rises from the inner side of 
the femoral artery close to the preceding vessels, and, after 
passing through the saphenous opening, courses inward 
across the spermatic cord, to be distributed to the integu¬ 
ment on the lower part of the abdomen, the penis and 
scrotum in the male, and the labium in the female, 
anastomosing with the branches of the internal pudic; 
the deep external pudic passes inward on the pectineus 
muscle, and, covered by the fascia lata, its branches are 
distributed in the male to the integument of the scrotum 
and perineum, and in the female to the labium, anas¬ 
tomosing with branches of the superficial perineal artery. 
The profunda femoris (B, plate 3, Lower Extremity) nearly 
equal in size to the superficial femoral, rises from the 
outer and back part of the femoral artery, a little below 
Poupart’s ligament. Lying on the outer side of the 
superficial femoral, and then passing behind it and the 
femoral vein to the inner side of the thigh bone, it termi¬ 
nates in a small branch in the lower third of the thigh. 
The external circumflex artery (L, back plate Body) sup¬ 
plies the muscles on the front of the thigh, and, rising 
from the outer side of the profunda, passes outward in a 
horizontal direction, and divides into three sets ofbranches — 
ascending , transverse, and descending. The internal cir¬ 
cumflex artery (F, back plate Body) rises from the inner 
and back part of the profunda, and winds around the inner 
side of the femur. On reaching the upper border of the 
adductor brevis, it gives off two branches, one of which 
passes inward, anastomosing with the obturator artery; 


i6o 

the other descends and passes beneath the adductor brevis 
to supply it and the great adductor, while the continua¬ 
tion of the vessel passes backward between the quadratus 
femoris and upper border of the adductor magnus, anasto¬ 
mosing with the sciatic external circumflex, and superior 
perforating arteries. The perforating arteries, usually 
three in number, are so called from their perforating ten¬ 
dons of the adductor brevis and magnus muscle. 

The popliteal artery (F, plated, Upper Extremity) com¬ 
mences at the termination of the femoral, at the opening 
in the adductor magnus, and, passing downward and out¬ 
ward behind the knee joint to the lower border of the 
popliteal muscle, divides into the anterior and posterior 
tilnal arteries (G, lower part plate 5. Lower Extremity), 
and through the whole of its extent lies in the popliteal 
space. 

The popliteal space (H, plate 5, Lower Extremity) occu¬ 
pies the lower third of the thigh and the upper fifth of the 
leg, extending from the aperture in the adductor magnus 
to the lower part of the popliteal muscle ; it is shaped 
like a lozenge, being widest at the back part of the 
knee joint, and deepest above the articular end of 
the femur. Its floor is formed by the lower part 
of the posterior surface of the shaft of the femur, the 
posterior ligament of the knee joint, the upper end of 
the tibia, and the fascia covering the popliteal muscle; the 
space is covered in by the fascia lata. It contains the 
popliteal vessels and their branches, the termination of the 
external saphenous vein, the internal and external popli¬ 
teal nerves and their branches, the small sciatic nerve, a 
few small lymphatic glands and a quantity of tissue. 

There are many branches given off by the popliteal 
artery, of which we will mention but three; the cutaneous 


i6i 


branches (f, plate 6, Lower Extremity), the superior articu¬ 
lar arteries and the inferiorarticular arteries. The cuta¬ 
neous branches descend on each side, and in the middle of 
the limb rise separately from the popliteal artery and sup¬ 
ply the integument of the calf of the leg. The superior 
articular arteries (plate 4, Lower Extremity) are two in 
number, and rise one on each side of the popliteal, and 
wind around the femur, immediately above its condyles, to 
thefront ot the knee joint; the superficial branch supplies 
the vastus externus, and anastomoses with a descending 
branch of the external circumflex artery. The inferior 
articular arteries (plate 4, Lower Extremity) are also two 
in number, and rise from the popliteal beneath the gastroc¬ 
nemius, and wind around the head of the tibia (1, lower 
part plate 5, Lower Extremity) below the joint, the inter¬ 
nal branch passes below the inner tuberosity, beneath the 
internal lateral ligament, at the anterior border of which 
it ascends to the front and inner side of the joint to sup¬ 
ply the head of the tibia and the articulation of the knee; 
the external branch passes outward above the head of the 
fibula to the front of the knee joint, and divides into 
branches which anastomose with the inferior internal artic¬ 
ular artery, the superior articular arteries, and the recur¬ 
rent branch of the anterior tibial. 

The anterior tibial artery (O, plate 5, Lower Extremity) 
commences at the bifurcation of the popliteal at the lower 
border of the popliteus muscle, passes forward between the 
two heads of the tibialis posticus, and through the aperture 
left between the bones at the upper part of the interosseous 
membrane to the deep part of the front of the leg ; it then 
descends on the anterior surface of the tibia to the bend 
of the ankle joint, where it lies more superficially and 
becomes the dorsalis pedis. A line drawn from the inner 


i62 


side of the head of the fibula to midway between the two 
malleoli will mark the course of the artery, the point where 
it comes in front of the interosseous membrane being in 
this line one and a quarter inches below the level of the 
head of the fibula. Or, if the foot is turned so as to loosen 
the muscles, the artery is then exposed deeply seated. 

The branches of the anterior tibial artery are the recur¬ 
rent tibial (B, lower part plate 5, Lower Extremity), mus¬ 
cular, internal malleolar , and external malleolar. The 
recurrent branch rises from the anterior tibial as soon as 
that vessel has passed through the interosseous space, and 
anastomoses with the articular branches of the popliteal 
artery; the muscular branches are many, and are distrib¬ 
uted to the muscles which lie on either side of the vessel, 
many of them anastomosing with the branches of the 
posterior tibial and peroneal arteries (H, lower part plate 
5, Lower Extremity) ; the malleolar branches supply the 
ankle joint, the internal rising about two inches above the 
articulation, and passing beneath the tendons of the 
extensor proprius pollicis and tibialis anticus, to the inner 
ankle, upon which it ramifies, anastomosing with branches 
of the posterior tibial and internal plantar arteries (L, 
lower part plate 5, Lower Extremity); the external passes 
beneath the tendons of the extensor longus digitorum and 
peroneus tertius, and supplies the outer ankle, anastomos¬ 
ing with the anterior peroneal arteries. 

The dorsalis pedis artery (A, lower part plate 5, Lower 
Extremity), the continuation of the anterior tibial, passes 
forward from the bend of the ankle, along the foot to the 
back of the first interosseous space, where it divides in two 
branches. This vessel in its course forward rests upon the 
astragalus, scaphoid and internal cuneiform bones, and is 
covered by the fascia; on its fibular side is the termination 


of the anterior tibial nerve, and it is accompanied by two 
veins. The branches of the dorsalis pedis artery are the 
tarsal (D, lower part plate 5, Lower Extremity), the meta¬ 
tarsal (E, lower part plate 5, Lower Extremity), the inter¬ 
osseous, the dorsalis hallucis , and the communicating. 
The tarsal artery rises from the dorsalis pedis, as that vessel 
crosses the scaphoid bone, passes in an arched direction 
outward, and, lying upon the tarsal bone, it anastomoses 
with branches from the metatarsal, external malleolar and 
external plantar arteries; the metatarsal rises a little in front 
of the preceding, passes outward to the outer part of the 
foot over the bases of the metatarsal bones, and anastomo¬ 
ses with the tarsal and external plantar arteries (M, lower 
partplate 5, Lower Extremity). The outermostinterosseous 
artery gives off a branch which supplies the outer side of 
the little toe. The dorsalis hallucis (F, lower plate 5, 
Lower Extremity) runs forward along the outer border of 
the first metatarsal bone, at the cleft between the first and 
second toes divides into two branches, one of which 
passes inward and is distributed to the inner border of 
the great toe, the other branch bifurcates to supply the 
adjoining sides of the great and second toes; the commu¬ 
nicating artery dips down into the sole of the foot and 
inosculates with the termination of the external plantar 
artery to complete the plantar arch; it here gives off two 
digital branches, one running along the inner side of the 
great toe on its plantar surface, the other passing forward 
along the first metatarsal space, where it bifurcates to sup¬ 
ply the adjacent sides of the great and second toes. 

The posterior tibial artery (G, lower part plate 5, Lower 
Extremity) is of large size, and extends obliquely down¬ 
ward from the lower border of the popliteus muscle, 
along the tibial side of the leg, to the inner ankle and 


164 


heel, where it divides beneath the origin of the abductor 
pollicis into the internal and external plantar arteries. At 
its origin it lies opposite the interval between the tibia 
(1, plate 5) and fibula (4, plate 5), and, as it descends, ap¬ 
proaches the inner side of the leg, lying behind the tibia. 
In the lower part of its course, it is situated midway 
between the inner malleolus (3, plate 5) and the os calcis. 
It is more superficial at its lower third, being covered by 
the integument and fascia only, and runs parallel with the 
tendo A chillis. It is accompanied by two veins and by 
the tibial nerve, which in the greater part of its course is 
situated on its outer side. 


VEINS. 

(Plate, Blood Formation.) 

The veins are the vessels which serve to convey the 
blood from the capillaries of the different parts of the 
body to the heart, and, like the arteries, they are found in 
nearly all the tissues of the body. They commence by 
minute plexuses which receive the blood from the capil¬ 
laries, communicate freely with each other, and in form 
are not cylindrical, as are the arteries, their walls being 
thi liner, and collapsed when they are empty. They are 
larger and more numerous than the arteries, and, with the 
exception of the pulmonary veins (17), which do not 
in capacity exceed the pulmonary arteries (5), the entire 
capacity of the venous system is decidedly greater than 
the arterial. 

Like the arteries, the veins consist of two separate and 
distinct systems, the pulmonary and systemic. The pul¬ 
monary veins, unlike other vessels of this kind, contain 
arterial blood, which they return from the lungs to the 
left auricle (26) of the heart. The systemic veins are con- 


cerned in the general circulation, and return the venous 
blood from the body to the right auricle (25) of the heart. 
The portal vein (23), an appendage to the systemic venous 
system, is confined to the abdominal cavity, returning 
venous blood from the viscera of digestion, and carrying 
it to the liver (32) by a single trunk of extra size, the 
vena porta (23). This vessel ramifies in the substance of 
the liver, and breaks up into a minute network of capil¬ 
laries, which then reunite to form the hepatic veins (19), 
by which the blood is conveyed to the inferior vena 
cava (18). 

The systemic veins are subdivided into three sets, 
i.e. t the superficial or subcutaneous veins, the deep veins 
and the sinuses. The superficial veins are found imme¬ 
diately beneath the integument, between the layers of the 
superficial fascia, and communicate with the deep veins by 
perforating the deep fascia. The deep veins have thinner 
coats, always accompany the arteries, and are usually in 
the same sheath. The larger arteries have usually but 
one accompanying vein ; but in the smaller arteries they 
exist in pairs, lying on each side of the artery, and are 
called the venae comites. Sinuses are venous channels 
which differ entirely from the veins. In the lower limbs 
the veins are much thicker than in the upper. 

THE PULMONARY VEINS. 

(See Plate, Blood Formation.) 

There are four pulmonary veins (17), each lung Hav¬ 
ing two, and their office is to convey the arterial blood 
from the lungs to the left auricle (26) of the heart. They 
differ from other veins in many respects ; first, they carry 
arterial instead of venous blood ; second, they have no 
valves; third, the)’ are only slightly larger than the arteries, 


i66 


which they accompany ; fourth they accompany those 
arteries singly. They commence in the capillary network 
upon the walls of the air-cells, where they are continuous 
with the ramifications of the pulmonary artery (5), and, 
uniting together, they form a single trunk for each lobule. 
Within the lung, the pulmonary artery (5) branches are 
in front, the veins behind, and the bronchi between the 
two ; at the root of the lung, the veins are in front, the 
artery in the middle, and the bronchi behind. 

THE SYSTEMIC VEINS. 

The systemic veins may be arranged into three groups: 
First, those of the head, neck, upper extremities, and 
thorax; second, those of the lower extremities, pelvis, and 
abdomen, which terminate in the inferior vena cava (18); 
third, the cardiac veins, which open directly into the right 
auricle (25) of the heart. 

The veins of the head and neck (see Head plate) may 
be subdivided into three groups: first, those of the exte¬ 
rior of the head; second, those of the neck; third, those 
of the diploe and interior of the cranium. 

The veins of the exterior of the head are the facial , 
(17, Head plate), the temporal (18), the internal maxillary 
(35), the temporo-maxillary , the posterior-auricular , and 
the occipital. The facial vein (17) crosses obliquely the 
side of the face, is on the outer side of the facial artery 
(20), and is not so tortuous as that vessel. The frontal 
vein commences on the anterior portion of the skull by a 
venous plexus, and communicates with the anterior tribu¬ 
taries of the temporal vein (18); occasionally the frontal 
veins join to form a single trunk, which bifurcates or 
branches at the root of the nose into the two angular 

o 

veins. The temporal vein commences by a minute plexus 


167 


on the side of the skull, and communicates with the frontal 
vein in front. The internal maxillary vein is quite large, 
and receives branches which correspond with branches of 
the internal maxillary artery; it receives several small 
veins, together forming a plexus of large size, which com¬ 
municates very freely with the facial vein (17). The 
temporo-maxillary vein is formed by the union of the 
temporal (18) and internal maxillary vein (3 5)- It 
descends in the substance of the parotid gland, on the 
outer surface of the external carotid artery (1, Blood 
Formation), between the jaw and the sterno-mastoid muscle, 
and divides into two branches; one passes inward and 
joins the facial vein (17), the other is joined by the pos¬ 
terior auricular vein and becomes the external jugular (16, 
Blood Formation). The posterior auricular vein com¬ 
mences on the side of the head by a plexus, which com¬ 
municates with the tributaries of the temporal and occi¬ 
pital veins; it descends behind the ear, and joins the 
temporo-maxillary vein, thus forming the external jugular 
vein. The occipital veins are three in number. They 
commence at the back part of the skull by a plexus, 
follow the course of the occipital artery, and usually ter¬ 
minate in the internal jugular vein, though sometimes 
their termination is found in the external jugular vein. 

The veins of the neck, which return the blood from the 
head and face, are the external jugular (16, Head plate), 
the anterior jugular , the posterior exteriial jugular , the 
internal jugular and the vertebral vein. The external 
jugular vein receives the greater part of the blood from the 
exterior of the cranium and deep parts of the face. It 
commences in the substance of the parotid gland, on a 
level with the angle of the lower jaw, and runs perpendic¬ 
ularly down the neck in the direction of a line drawn from 


the angle of the jaw to the middle of the clavicle (13, Skele¬ 
ton plate). It then crosses the sterno-mastoid muscle, and 
runs parallel with its posterior border as far as its attach¬ 
ment to the clavicle, where it perforates the deep fascia 
and terminates in the subclavian vein (15, Blood Forma¬ 
tion). The external jugular vein varies in size, and is 
sometimes found double. It has two pairs of valves, the 
lower situated at its entrance into the subclavian vein, the 
upper about one or two inches above the clavicle. These 
valves do not prevent the regurgitation of the blood or the 
passage of an injection from below upward. The poste¬ 
rior external jugular vein returns the blood from the integu¬ 
ment and superficial muscles in the upper and back part 
of the neck; it runs down the back part of the neck, and 
opens into the external jugular vein just below the middle 
of its course. The anterior jugular vein, or veins, for 
most frequently there are two, commence near the hyoid 
bone (19, Body plate), and pass down between the median 
line and the anterior border of the sterno-mastoid (18, 
Body plate). These veins vary extremely in size, and 
communicate with the jugular veins. They have no valves, 
and consequently can be injected. The internal jugular 
vein collects the blood from the interior of the cranium, 
from the superficial parts of the face, and also from the 
neck. It commences just externally to the jugular fora¬ 
men, in the base of the skull, runs down the side of the 
neck in a vertical direction, lying at first on the outer side 
of the internal carotid, and then on the outer side of the 
common carotid arteries (19, Head plate). At the root of 
the neck it unites with the subclavian vein to form the 
vena innominata (14, Blood Formation); this vein is some¬ 
times quite large, and is provided with one pair of valves, 
which usually are at its termination, though sometimes 


i6 9 


they are placed a little above. The vertebral vein com¬ 
mences in the occipital region by numerous small tribu¬ 
taries from the deep muscles at the upper and back part of 
the neck, passes outward and enters the foramen in the 
transverse process of the atlas; descends by the side of the 
Vertebral artery in the canal formed by the transverse pro¬ 
cesses of the cervical vertebrae, emerges from the foramen 
in the transverse processes of the six cervical vertebrae, and 
terminates at the root of the neck in the back part of the 
innominate vein (14, Blood Formation). Near its origin its 
mouth is guarded by one pair of valves. On the right side 
it crosses the first part of the subclavian artery (3, Blood 
Formation). 

THE SUPERFICIAL VEINS OF THE UPPER EXTREMITY. 

(See plate, Upper and Lower Extremities.) 

The superficial veins are placed immediately beneath 
the integument between the two layers of superficial 
fascia, and commence in the hand, chiefly on its dorsal 
aspect, where they form a more or less complete arch. 
They are, namely, the anterior ulnar , posterior ulnar , 
radial , median , median basilic , median cephalic basilic , 
and cephalic. 

The anterior ulnar vein commences on the anterior sur¬ 
face of the ulnar side of the hand and wrist, and continues 
its course along the inner or ulnar side of the forearm to 
the bend of the elbow, where it joins with the posterior 
ulnar vein to form the basilic; occasionally, it opens in the 
median basilic vein. The posterior ulnar vein commences 
on the posterior surface of the ulnar side of the hand, and 
from the vein of the little finger (the vena salvatella), it runs 
on the posterior surface on the ulnar side of the forearm, 
and, just below the elbow, unites with the anterior ulnar 


vein to form the basilic vein. Sometimes it joins the median 
basilic (5) to form the basilic vein, (II.) and it also communi¬ 
cates by a branch with the deep veins of the palm. The 
common ulnar vein is a short trunk which is not constant; 
when it does exist, it is formed by the junction of the 
two preceding veins. The radial vein (HI.) commences 
from the dorsal surface of the thumb, index finger, and 
radial side of the hand, communicates with the vena sal- 
vatella and with the deep veins of the palm by a branch 
which passes through the first interosseous space; at the 
bend of the elbow it unites with the median cephalic 
to form the cephalic vein, (HI.) The median vein (IV.) 
collects the blood from the superficial structures on 
the palmar surface of the hand and median line of 
the forearm, and, communicating with the anterior 
radial and ulnar veins at the bend of the elbow, it 
receives a branch of communication from the deep veins 
accompanying the brachial artery (A), and divides into 
two branches, which diverge from each other as they 
ascend. The median basilic vein (V.) passes inward in 
the groove of the biceps muscle, and joins the common 
ulnar to form the basilic vein; it passes in front of the 
brachial artery, and is separated from it by the bicipital 
fascia. The basilica vein (II.) is very large, and, formed by 
the common ulnar vein with the median basilic, it passes 
upward along the line of the biceps muscle on the inner 
side, and ascends in the course of the brachial artery 
(A). The cephalic vein (III.) courses along the outer bor¬ 
der of the biceps muscle to the upper third of the arm; it then 
passes in the interval between the pectoralis major and del¬ 
toid muscles, and terminates in the axillary vein just below 
the clavicle; this vein is sometimes connected with the 


external jugular or subclavian by a branch which passes 
Irom it upward in front of the clavicle 

1HE DEEP VEINS OF THE UPPER EXTREMITY. 

(Same plate.) 

The deep veins of the upper extremities follow the 
course of the arteries, forming their venae comites. These 
are two in number, one lying on each side of the corre¬ 
sponding artery, and are connected by short transverse 
branches a little distance apart. There are two digital 
veins accompanying each artery along the sides of the 
fingers, and there, uniting at their base, they pass along the 
spaces into the palm of the hand, and terminate in the two 
venae comites, which accompany the superficial palmar 
arch. The deep ulnar veins, as they pass in front of the 
wrist, communicate with the interosseus and superficial 
veins, and at the elbow unite with the deep radial veins, 
to form the venae comites of the brachial artery (A). 
The interosseous veins accompany the anterior and pos¬ 
terior interosseous arteries; the anterior interosseous veins 
commence in the front of the wrist, where they communi¬ 
cate with the deep radial and ulnar veins, and terminate 
in the venae comites of the ulnar artery (G, Sec. 4). 
The deep palmar veins accompany the deep palmar arch, 
communicate with the superficial palmar veins at the inner 
side of the hand, and on the outer side terminate in the 
venae comites of the radial artery (B, section 2). At the 
wrist they receive branches which unite with the deep 
radial vein, as they are in company with the radial 
artery, and terminate in the venae comites of the brachial 
artery (A, section 2). The brachial veins (V, section 2) 
are situated one on either side of the brachial artery. At 
the lower margin of the axilla they unite with the basilic 


172 


to form the axillary vein. All the deep veins have many 
anastomoses, not only with each other, but with many of 
the superficial veins. 

VEINS OF THE SHOULDER AND CHEST. 

The axillary vein is of large size, and is formed by the 
junction of the venae comites of the brachial artery with 
the basilic vein. It begins at the lower part of the axil¬ 
lary space, increases in size as it ascends by receiving 
tributaries corresponding with the branches of the axillary 
artery, and terminates immediately beneath the clavicle, 
at the outer margin of the first rib, where it becomes the 
subclavian vein. Near its termination it receives the 
cephalic vein. The subclavian vein (5, Blood Formation) 
is the continuation of the axillary. It extends from the 
outer margin of the first rib to the inner end of the sterno¬ 
clavicular articulation, where it unites with the internal 
jugular to form the innominate veins (14, Blood Formation). 
It occasionally rises in the neck to a level with the third 
part of the subclavian artery (3, Blood Formation). The 
innominate veins are two large trunks (14, Right and Left), 
laid one on each side of the root of the neck, and formed 
by the union of the internal jugular and subclavian veins 
of the corresponding side. There is but one innominate 
artery (3, Blood Formation). The right innominate vein 
is short, about one and one-half inches in length, com¬ 
mences at the inner end of the clavicle, and, passing down¬ 
ward, joins the left vena innominata just below the first 
rib, near the right border of the sternum, forming the 
superior vena cava (13, Blood Formation). It is super- 
' facial and external to the arteria innominata. The left 
innominate vein is about three inches in length, and larger 
than the right. It passes from left to right across the 


173 


chest, inclines downward to unite with its fellow of the 
opposite side, thus forming the superior vena cava. The 
internal mammary veins are two in number to each artery, 
and follow the course of the artery of the same name. 
The superior intercostal veins return the blood from the 
upper intercostal spaces. The right vein is much smaller 
than the left, and corresponds with the superior inter¬ 
costal artery. The left superior intercostal vein varies 
in size, being smaller when the left upper azygos vein 
is large, and vice versa. The superior vena cava 
(13, Blood Formation) receives the blood which is 
conveyed to the heart from the whole of the upper 
half of the body, and also the contents of the 
right lymphatic (37, Blood Formation) and thoracic ducts 
(29, Blood Formation). It is a short, valveless trunk, 
varying from two inches and a half to three inches in 
length, and is formed by the junction of the two venae 
innominatae. It enters the pericardium about one inch 
and a half above the heart, and terminates in the upper 
part of the right auricle. Just before it enters the peri¬ 
cardium it receives the vena azygos major (13, Blood For¬ 
mation). The azygos veins connect the superior and 
inferior venae cavae, supplying the place of those vessels in 
the part of the chest which is occupied by the heart. 
The right, or larger azygos vein — azygos major — (1, rear 
section of Body plate) begins opposite the first or second 
lumbar vertebra by a branch from the right lumbar veins, 
and sometimes by a branch from the inferior vena cava. 
It enters the thorax through the aortic opening in the 
diaphragm, passes along the right side of the vertebral 
column, and terminates in the superior vena cava, just- 
before that vessel enters the pericardium. In the thorax, 
it lies upon the intercostal arteries on the right side of the 


174 


aorta. The left or smaller azygos vein (azygos minor) 
begins in the lumbar region by a branch from one of the 
lumbar veins, passes into the thorax through the left crus 
of the diaphragm, ascends on the left side of the spine as 
high as the sixth or seventh dorsal vertebra, and terminates 
in the right azygos vein. The bronchial veins return the 
blood from the substance of the lungs, the right vein open¬ 
ing into the vena azygos major, the left into the left 
superior intercostal vein. 

THE SPINAL VEINS. 

The spinal veins are arranged in four sets: the dorsi- 
spinal veins, or those situated on the exterior of the spinal 
column; the meningo-rachidian veins, or those situated 
in the interior of the spinal canal; the vence bases verte- 
brarum , or the veins of the bodies of the vertebra ; the 
medulli-spinal , or the veins of the spinal cord. 

The dorsi-spinal veins commence by small branches 
which receive their blood from the back of the spine and 
from the muscles in the vertebral grooves. They form a 
network which surrounds the spinous process, the laminae, 
and the transverse and articular processes of all the verte¬ 
brae. They terminate by joining the vertebral veins in the 
neck, the intercostal veins in the thorax, and the lumbar 
and sacral veins in the loins and pelvis. 

The meningo-rachidian veins, the principal veins con¬ 
tained in the spinal canal, are situated between the theca 
vertebralis and the vertebrae, and are two in number, the 
anterior longitudinal spinal vein, and the posterior longi¬ 
tudinal spinal vein. The anterior longitudinal spinal vein 
consists of two large tortuous venous canals which extend 
along the whole length of the vertebral column from the 
foramen magnum to the base of the coccyx (26, Skeleton 


i75 


plate); the posterior longitudinal spinal veins are smaller 
than the anterior, and are situated one on either side 
between the inner surfaces of the laminae and the theca 
vertebralis. Like the anterior veins, they communicate 
opposite each vertebra by transverse trunks. 

The veins of the bodies of the vertebrae emerge from the 
foramina on their posterior surface, and join the transverse 
trunk connecting the anterior longitudinal spinal veins. 
In advanced age they become greatly developed. 

The veins of the spinal cord are valveless, and consist 
of a tortuous venous plexus which covers the entire sur¬ 
face of the cord, and is situated between the pia mater and 
arachnoid. Near the base of the skull these veins unite 
and form several small trunks, which communicate with 
the vertebral veins, and there terminate in the interior 
cerebellar veins. There are no valves in the spinal veins, 
and, as a consequence, they get thoroughly injected with 
the fluid. 

THE SUPERFICIAL VEINS OF THE LOWER EXTREMITY. 

(See plate, Upper and Lower Extremity.) 

The veins of the lower extremity are more fully sup¬ 
plied with valves than those of the upper, and are divided 
into two sets, superficial and deep. The superficial veins 
are placed beneath the integument between the two lay¬ 
ers of superficial fascia ; and are subdivided into the in¬ 
ternal or long saphenous , and the external or short saphe¬ 
nous veins. The internal or long saphenous vein (i, Sec. i) 
is very easily seen. It commences at the inner side of 
the arch on the dorsum of the foot, ascends in front of the 
inner malleolus and along the inner side of the leg ; at 
the knee it passes backward behind the inner condyle of 
the femur, or thigh bone (i, Sec. 4), then ascends along 


the inside of the thigh, and terminates in the femoral vein 
(i , plate 2 and 3, Leg) about one inch and a half below 
Poupart’s ligament. This vein (1, Sec. 1, Leg) communi¬ 
cates in the foot with the internal plantar vein, in the leg 
with the posterior tibial veins, at the knee with the articu¬ 
lar veins, and in the thigh with the femoral vein. It pos¬ 
sesses from two to six valves, more numerous in the thigh 
than in the leg. The external or short saphenous vein 
commences at the outer side of the arch on the dorsum of 
the foot, ascends behind the outer malleolus, and along 
the outer border of the tendo Achilles, passes directly 
upward, and terminates in the popliteal vein. Before it 
perforates the deep fascia, it gives off a communicating 
branch, which passes upward to join the internal saphenous 
vein. It also has a number of valves, one of which is 
always found at its termination in the popliteal vein. 

THE DEEP VEINS OF THE LOWER EXTREMITY. 

(See plate, Upper and Lower Extremity.) 

The deep veins of the lower extremity accompany the 
arteries and their branches, and are called the vense 
comites of these vessels. They are more fully supplied 
with valves than the superficial veins, and are largely sub¬ 
divided. The external and internal plantar veins (F, 
plate 5, Leg and Foot) unite to form the posterior tibial 
veins, which accompany the posterior tibial artery, and 
are joined by the peroneal veins. The anterior tibial 
veins are formed by a continuation upward of the venie 
comites of the dorsalis pedis artery (A, plate Leg). 
They pass between the bones of the leg, tibia and fibula, 
and form, by their junction with the posterior tibial (plate 
5, Lower Extremity), the popliteal vein (plate 5, Lower 
Extremity). 


i77 


The popliteal vein is formed by the junction of the 
venm comites of the anterior and posterior tibial vessels, 
ascends through the popliteal space, and becomes the 
femoral vein (plate 5, Lower Extremity). In this vein 
theie are usually four valves, and in the lower part of its 
course it is placed internal to the artery. 

The femoral vein possesses four or five valves, and 
accompanies the femoral artery through the upper two- 
thirds of the thigh, in its lower course lying on the outside, 
and higher up back of the artery. Near its termination 
it is joined by the profunda femoris vein, and again, about 
one and one-half inches below Poupart’s ligament, by the 
internal saphenous vein. 

ABDOMINAL VEINS. 

The external iliac vein (F, back plate Body) commences 
at the termination of the femoral vein, beneath the crural 
arch, passes upward and terminates opposite the sacro-iliac 
symphysis by uniting with the internal iliac (F, back plate 
Body) to form the common iliac vein (G, back plate Body). 
The internal iliac vein (F, back plate Body) is formed by 
the venae comites of the branches of the internal iliac 
artery (F, back plate Body), and lies at first on the inner 
side and then behind the internal iliac artery. It termi¬ 
nates opposite the sacro-iliac articulation by uniting with 
the external iliac to form the common iliac vein. This 
vessel has no valves. The dorsal vein of the penis (plate, 
Male Genital Organs) is a vessel of large size, which 
returns the blood from the body of that organ. The com¬ 
mon iliac veins (G, back plate Body) are formed by the 
union of the external and internal iliac veins in front of 
the sacro-vertebral articulation. Passing upward toward 
the right side, they terminate upon the intervertebral sub- 


178 


stance between the fourth and fifth lumbar vertebra (12, 
Skeleton plate), where the veins of the two sides unite at 
an acute angle to form the inferior vena cava (E, back plate 
Body). The right common iliac vein is shorter than the 
left, and ascends behind and then to the outer side of its 
corresponding artery. The left common iliac vein (G, back 
plate Body) is more oblique in its course, and is situated 
at first on the inner side of its corresponding artery, and 
then behind the right common iliac artery. No valves are 
found in these veins. 

The inferior vena cava (E, back plate Body) returns to 
the heart the blood from all the parts below the dia¬ 
phragm. It is formed by the junction of the two common 
iliac veins (G, back plate Body), passes upward along the 
front of the spine on the right side of the aorta (A, back 
plate Body), then through a groove under the liver, and, 
perforating the tendinous center of the diaphragm, enters 
the pericardium, and terminates in the lower part of the 
right auricle of the heart. At its termination in the 
auricle, it is provided with a valve called the Eustachian 
valve. 

The renal veins (W, back plate Body) are of large size, 
and are placed in front of the renal artery (V, back plate 
Body). The left is longer than the right, and, passing in 
front of the aorta, just below the origin of the superior 
mesenteric artery (Y, back plate Body), it opens a little 
above the right into the vena cava (E, back plate Body). 
The supra-renal veins terminate on the right side in the 
vena cava, and on the left side in the left renal or phrenic 
vein. The phrenic veins, two superior and two inferior, 
follow the course of the phrenic arteries. The hepatic 
veins (19, Blood Formation), three in number, commence 
in the substance of the liver, in the capillary terminations 













. 























I . ! is — i I 

. 

•-». -- •— 





■ 







PRACTICAL ANATOMY FOR THE EMBALMER 



mmimmPl 

■ V 




Superior Mesenteric A. 




5mall InlesliriE 




A Few of the Parts from a Human Subject in twenty Dissections, showing 
the exact positions of the Arteries, Veins, Nerves and Muscles throughout the human 
body, also the organs of the Thoracic and Abdominal Cavities in their normal places. 


Arch nFAorta 
Innominate A.- 
Aor/j 

Superior Vena Cava 
Right Pulmnnarg A. 


Left Common Carotid A. 
LeFtSobDavianA. 
Pulmonary A. 

LeFt Pulmonary A. 
LrFt Pulmonary V, 


flight Pulmonary V 
Right Auricle 
RightLung 

Pericardium 
Liver 

Bad Bladder 

Superior Mesenteric Vr 

Duodenum 
InFeriur Vena Cava 

RighfCommon Iliac A. 
Right Common Iliac V. 

Ascending Colon 


LeFtLung 
LeFt Ventricle 


■Right Ventricle 

Pericardium 

Diaphragm 


—-Stomach 
— Transverse Colon 


Descending Colon 
- Abdominal Aorta 


LeFtCommonPiacA. 
■LeFt Common Iliac V 


ORGANS OF THE THORACIC AND ABDOMINAL CAVITIES. 

Copyright, 1903, by H. S. Eckels & Co. 











































1 79 


of the portal vein (23, Blood Formation). They run singly, 
and have no valves. 

THE PORTAL VENOUS SYSTEM. 

The portal venous system is composed of four large 
veins which collect the venous blood from the viscera of 
digestion. The trunk formed by their union — the vena 
porta (23, Blood Formation) — enters the liver, ramifies 
throughout its substance and its branches, and emerges 
from that organ as the hepatic veins (19, Blood Formation), 
which terminate in the inferior vena cava (18, Blood Form¬ 
ation). 

The branches of these veins are in all cases single, and 
destitute of valves. The veins forming the portal system 
are the inferior mesenteric (22, Blood Formation), the supe¬ 
rior meseiiteric (22, Blood Formation), the splenic (21, 
Blood Formation), and the gastric (20, Blood Formation). 
The inferior mesenteric vein returns the blood from the 
rectum, sigmoid flexure (14, Intestine plate), and the 
descending colon (14, Intestine plate). The superior mesen¬ 
teric vein returns the blood from the small intestines, the 
caecum, and ascending and transverse portions of the colon, 
corresponding with the distribution of the branches of the 
superior mesenteric artery 

The splenic vein (21, Blood Formation) commences by 
five or six large branches which return the blood from the 
substance of the spleen ; these unite and form a single 
vessel, which passes from left to right behind the upper 
border of the pancreas (19, back plate Body) below the 
artery, and terminates at its greater end by uniting at a 
right angle with the superior mesenteric vein to form the 
vena porta. The splenic vein is large, and not tortuous 
like the artery. The gastric veins (20, Blood Formation) 


i8o 


are two in number: one, a small vein, corresponds to the 
pyloric branch of the hepatic artery (8, Blood Formation); 
the other, much larger, corresponds to the gastric artery 
(7, Blood Formation). The former, pyloric, runs along the 
lesser curvature of the stomach toward the pyloric, 
receives branches from the pylorus (4, Stomach) and duode¬ 
num (5, Stomach), and ends in the vena porta. The latter, 
coronary, begins near the pylorus, runs along the lesser 
curvature of the stomach, and then curves downward be¬ 
tween the folds of the lesser omentum to end in the vena 
portae (23, Blood Formation). The portal vein is formed 
by the junction of the superior mesenteric and splenic 
veins, their union taking place in front of the vena cava 
(18, Blood Formation), and behind the upper border of the 
great end of the pancreas. The portal vein is about four 
inches in length, and lies behind the hepatic duct and 
artery — the former to the right, the latter to the left. 
Within the liver the portal vein receives the blood from 
the branches of the hepatic artery. 

# 

THE CARDIAC VEINS. 

The cardiac veins are the veins which return the blood 
from the substance of the heart, and are, namely, th z great 
cardiac vein, the middle cardiac vein, the posterior cardiac 
vein, the anterior cardiac veins, the right or small cardiac 
vein, and the vena Thebesii. The great cardiac vein (Heart) 
— coronary — is a vessel of considerable size which com¬ 
mences at the apex of the heart, and ascends along the 
anterior interventricular groove to the base of the ventri¬ 
cles (Heart). The middle cardiac vein commences by small 
tributaries at the apex of the heart, ascends along the pos¬ 
terior interventricular groove to the base of the heart, and 


i S i 


terminates in the coronary sinus. Its orifice is guarded 
by a valve. 

The posterior cardiac veins are four small vessels which 
collect the blood from the posterior surface of the left 
ventricle (Heart), and open into the lower border of the 
coronary sinus. The anterior cardiac veins (Heart) are 
three small vessels which collect the blood from the 
anterior surface of the right ventricle (Heart), and open 
separately in the lower part of the right auricle (Heart). 
The right or small coronary vein (Heart) runs along the 
groove between the right auricle (Heart) and ventricle 
(Heart) to open into the right extremity of the coronary 
sinus. It receives blood from the back part of the right 
auricle (Heart) and ventricle (Heart). The venae Thebesii 
are many minute veins which return the blood directly 
from the muscular substance without entering the venous 
current. They open by minute orifices on the inner 
surface of the right auricle (Heart). The coronary sinus 
is that portion of the great cardiac vein which is situated 
in the posterior part of the left auriculo- ventricular groove. 
It is about one inch in length, presents considerable dilata¬ 
tion, and receives the veins enumerated above. The 
coronary sinus terminates in the right auricle (Heart), its 
orifice being guarded by the coronary valve. All these 
vessels are provided with valves. The description given 
here of the veins will serve our purpose in the art of 
embalming, and it is unnecessary for us to go into further 
details. 


THE BRAIN AND ITS MEMBRANES. 

(See Head section in Aid.) 

The brain is that portion of the cerebro-spinal axis con¬ 
tained in the cranial cavity. It is divided into four princi- 


182 


pal parts, named the medulla oblongata (30), the pons 
Varolii, the cerebellum (28), and the cerebrum (27). The 
medulla oblongata extends from the lower border of the 
pons to the upper part of the spinal cord, with which it is 
continuous. The pons is that part of the brain which 
rests upon the upper portion of the basilar process (58) 
and body of the sphenoid bone. The cerebellum, the 
little or after brain, is situated in the inferior pair ol occipital 
fossae. It consists both of gray and white matter, and its 
outer surface has a foliated appearance, due to its subdi¬ 
vision by numerous fissures. The cerebrum forms the 
largest portion of the brain, and lies above both the pons 
and cerebellum. It is composed both of gray and white 
matter, is ovoid in shape, is subdivided into hemispheres, 
and its surface presents a series of convolutions, separated 
from each other by fissures. Of these, the five principal 
fissures are the great longitudinal fissure, separating the 
hemispheres, and the fissure of Sylvius, the fissure of 
Rolando, and the parieto-occipital fissure, which separates 
the lobes of the brain. The membranes of the brain are 
the dura mater, the arachnoid, and the pia mater. The 
dura mater is a thick, inelastic fibrous membrane, which 
lines the interior of the skull, its numerous arteries being 
distributed to the bone. The arachnoid — so named from 
its resemblance to a spider’s web—is a delicate, trans¬ 
parent membrane, which loosely envelopes the brain, its 
structure consisting of bundles of white, fibrous and 
elastic tissue intimately blended. It lies between the 
dura and pia mater. The pia mater is a vascular mem¬ 
brane closely investing the whole outer surface of the 
brain and dipping into the fissures. 


183 

THE PHARYNX. 

The pharynx (50, Head plate) is that part of the alimen¬ 
tary canal which is situated behind the nose, mouth and 
larynx (56, Head Plate). 

It is conical in form, its base upward and apex down¬ 
ward, is about four and a half inches in length, and broader 
in its transverse than in its antero-posterior diameter. 
Below, it is continuous with the oesophagus (57). The 
pharynx is composed of three coats, mucous, fibrous and 
muscular; the fibrous coat, situated between the mucous 
and muscular layers, is called the pharyngeal aponeurosis. 

THE (ESOPHAGUS. 

(See 57, Head plate in Aid.) 

The oesophagus, or gullet (57), is a muscular canal about 
nine inches in length, extending from the pharynx (50) 
to the stomach. 

It passes through the diaphragm, and, entering the abdo¬ 
men, terminates at the cardiac orifice of the stomach (3, 
plate of stomach), opposite the ninth dorsal vertebra. 
The oesophagus has three coats, an external or muscular, 
a middle or areolar, and an internal or mucous coat. 

THE THORAX. 

The thorax is a conical framework, made up partly of 
bones, and partly of soft tissues connecting them. It is 
narrow above, broad below, flattened before and behind ; 
is bounded in front by the sternum, the six upper costal 
cartilages, the ribs and intercostal muscles ; at the sides 
by the ribs and the intercostal muscles, and behind by the 
dorsal vertebra column. The superior opening of the 
thorax is bounded on each side by the first rib, in front 
by the upper part of the sternum (6), and behind by the 


184 


first dorsal vertebra. It is broader from side to side than 
from before backward, its direction being forward and 
upward. The lower opening or base is bounded in front 
by the cusiform cartilage, behind by the last dorsal verte¬ 
bra, and on each side by the last rib, the diaphragm filling 
in the intervening space. Passing through the upper 
opening of the thorax are the sterno-hyoid and sterno¬ 
thyroid muscles, the trachea (24, Head), the oesophagus 
(57), the thoracic duct (29, Blood Formation), and the 
longus colli muscles of each side ; at the sides the arteria 
innominata (2, Blood Formation), the left common carotid 
(1, Blood P'ormation), left subclavian arteries (3, Blood 
P'ormation), and many other smaller parts. The apex of 
each lung, covered by the pleura, also projects through 
this aperture a little above the margin of the first rib. 
The viscera contained in the thorax are the heart, inclosed 
in the pericardium; and the lungs, invested by the pleura. 

THE HEART. 

(Body Section of Aid, also Blood Formation.) 

The heart is a hollow muscular organ of a conical form, 
placed between the lungs, and inclosed in the cavity of the 
pericardium. The pericardium is a conical membranous 
sac, which, with the inclosed heart and the commencement 
of the great vessels, lies behind the sternum (6, Body plate), 
its apex upward, its base attached to the central tendon. 
Externally, the pericardium is a strong fibrous membrane. 
The position of the heart in the chest is oblique, its base 
directed upward and to the right, its apex directed down¬ 
ward, forward, and a little to the left. It is placed behind 
the lower two-thirds of the sternum, and projects farther 
into the left cavity of the chest than into the right. Its 
anterior surface is round and convex, its posterior flattened 


and resting upon the diaphragm; the right border is thin 
and sharp, the left border short, but thick and round. 
In the adult, the heart measures five inches in length, 
three and one-half inches in breadth at broadest part, and 
two and one-half inches in thickness; its average weight 
in the male is ten ounces, in the female about eight ounces. 
The heart is subdivided, by a longitudinal muscular septum, 
into lateral halves, which are named, from their position, 
the right and the left. A transverse constriction divides 
each half of the organ into two cavities, the upper cavities 
on each side being called the auricles, and the lower cav¬ 
ities the ventricles. The right auricle (25, Blood Forma¬ 
tion) receives the blood from all parts of the body by the 
ascending (18, Blood Formation) and descending (1 3, Blood 
Formation) venae cavse, and forces it through the auriculo- 
ventricular orifice (8, Body Section) into the ventricles for 
its entrance into the pulmonary artery (5, Blood Forma¬ 
tion), so that in its passage through the lungs the blood 
becomes oxidized or aerated before its entrance into the 
left side of the heart for its final distribution throughout 
the general system. The right auricle (25, Blood Forma¬ 
tion) is a trifle larger than the left, its walls being thinner, 
and its cavity capable of holding about two ounces of 
blood. The auriculo-ventricular orifice is a large oval 
aperture, about one inch in diameter, between the auricle 
and ventricle. The heart contains valves which open 
when the auricle contracts, and close when the auricle 
dilates, thus preventing regurgitation. 

THE LUNGS. 

(See Body plate in Aid.) 

The lungs are two large, spongy masses situated in the 
cavity of the chest, and extending from the first rib to the 


186 


diaphragm. They receive the blood from the pulmonary 
artery and oxidize or aerate it, sending it purified to the 
left side of the heart to be distributed to its general circu¬ 
lation. In shape the lungs are conical, and present an 
apex, a base, two borders and two surfaces. The apex 
extends into the root of the neck about one inch above 
the level of the first rib. The base is broad, and rests 
upon the convex surface of the diaphragm; the posterior 
border is round and broad, and is received in the deep 
concavity on either side the spinal column; the interior 
border is thin and sharp and laps over the front of the 
pericardium. The two lungs are in contact in the middle 
line, the pleura only being interposed. Each lung is 
divided into two lobes. The pleura, which invests each 
lung on its external surface, is an exceedingly delicate 
sac-shaped membrane, and incloses the lung as far as its 
root. The interspace or cavity between the layers is 
called the cavity of the pleura. 

THE STOMACH. 

(See plate of Stomach in body of Aid.) 

The stomach is the principal organ of digestion. It is 
placed immediately behind the anterior wall of the abdomen, 
above the transverse colon (12), below the liver (1-2) and 
the diaphragm. Its size varies in different individuals, 
but when moderately full its transverse diameter is usually 
about twelve inches, its vertical diameter four inches, its 
weight five ounces. It has two orifices, two extremities, 
two borders, and two surfaces. Its left extremity, called 
the greater or splenic end, is the largest part of the stom¬ 
ach, and extends two or three inches to the left of the 
point of entrance of the oesophagus (1); the pyloric end 
(4) is much smaller. The oesophageal or cardiac orifice 


i8y 

(2) communicates with the oesophagus, is the highest part 
of the stomach, and is somewhat funnel shaped; the 
pyloric orifice(4) communicates with the duodenum (5), the 
aperture being guarded by a valve — the pylorus (4). The 
structure of the stomach consists of four coats. The arte¬ 
ries supplying the stomach are the gastric (7, Blood Forma¬ 
tion), the pyloric and right gastro-epiploic branches of 
the hepatic (8, Blood Formation), the left gastro-epiploic 
and vasa brevia from the splenic (9, Blood Formation). 

THE INTESTINES. 

(See Intestine plate in body of Aid.) 

The small intestine is that part of the alimentary canal 
in which the chyme is mixed with the bile, the pancreatic 
juice and the secretions of the various glands imbedded 
in the mucous membrane of the intestine, and also where 
the separation of the chyle, the nutritive principle of the 
food, is effected. It is a convoluted tube about twenty 
feet in length, gradually diminishing in size from its com¬ 
mencement to its termination, and contained in the cen¬ 
tral and lower parts of the abdominal cavity, surrounded 
above and at its sides by the large intestine. The small 
intestine is divided into three portions, the duodenum .(5, 
Body), the jejunum (7), and the ileum (7). The duode¬ 
num is about ten inches in length, and is the shortest, the 
widest and the most fixed part of the small intestine. It 
has no mesentery, and is only partly covered by the peri¬ 
toneum (A 2) ; its curve is similar to a horse-shoe in form, 
the convexity directed to the right, the concavity to the 
left, and, embracing the head of the pancreas (19, Body), it 
terminates in the jejunum on the left side of the second 
lumbar vertebra. The jejunum, so called because it is 

usually found empty after death, includes the upper two- 

6 


i88 


fifths of the small intestine. Tt commences at the duode¬ 
num and terminates in the ileum, and, though wider and 
possessing coats thicker and of a deeper color than those 
of the ileum, it is very difficult to distinguish the line of 
demarkation of the two vessels. The ileum (7), so called 
from its numerous coils or convolutions, includes the 
remaining three-fifths of the small intestine, and terminates 
in the right iliac fossa by opening into the inner side of 
the commencement of the large intestine. The ileum is 
narrower, its coats thinner, and less vascular than those of 
the jejunum. 

The large intestine commences at the ileum, and termi¬ 
nates at the anus. It is about five feet in length, being 
one-fifth of the whole extent of the intestinal canal, is 
largest at its commencement, and gradually diminishes as 
far as the rectum, where there is a dilatation of consider¬ 
able size just above the anus. It differs from the small 
intestine in its greater size, its more fixed position, and 
its sacculated form. Commencing in the right side (the 
caecum) (9), it ascends to the under part of the liver, 
travels across the abdomen through the epigastric and 
umbilical regions to the left hypochondriac region, 
descends to the left iliac fossa, where it forms the sigmoid 
flexure, then descends through the pelvis to the anus, in 
its course having described an arch surrounding the con¬ 
volution of the small intestine. The large intestine is 
divided into three sections or divisions, called the caecum 
(9), the colon (14), and the rectum. The caecum, that 
part or sac in which the large intestine commences, is two 
and one quarter inches in length, in breadth three inches. 
The colon (14) is divided into four parts, the ascending, 
the descending, the transverse and the sigmoid flexure 
(last plate Female Genital Organs). The ascending 


^olon (io) is smaller than the caecum ; the transverse 
colon (12) is the longest part of the large intestine, and 
passes transversely across the abdomen from right to left, 
in its course describing an arch ; the descending colon 
passes almost vertically downward to the left iliac fossa, 
where it terminates; the sigmoid flexure, the narrowest 
part of the colon, is situated in the left iliac fossa, com¬ 
mencing where the descending colon terminates, and end¬ 
ing in the rectum ; the rectum is the terminal part of the 
large intestine, and extends from the sigmoid flexure to 
the anus, and is from six to eight inches in length. The 
large intestine has four coats, the serous, the muscular, 
the cellular, and the mucous. Both the large and small 
intestine are supplied with blood by the superior and 
inferior mesenteric arteries (11, Blood Formation), as well as 
from many of the abdominal branches, which are all 
branches from the aorta (4, Blood Formation). 

THE ABDOMEN. 

(See Body Section of Aid.) 

The abdomen is the largest cavity in the body. It is 
oval in form, and is bounded in front and at the sides by 
the lower ribs and the abdominal muscle, behind by the 
vertebral colnmn, above by the diaphragm, and below by 
the brim of the pelvis. The abdomen contains the greater 
part of the alimentary canal, and some of the accessory 
organs to digestion; viz., the liver, pancreas, and spleen, 
and the kidneys and supra-renal capsules. For con¬ 
venience of description, the abdomen is divided into nine 
separate regions ; the right upper region is called the 
right hypochondriac, the left upper region the left hypo¬ 
chondriac, the upper center region the epigastric, the right 
center region the right lumbar, the central region the 


190 

umbilical, the left central region the left lumbar, the 
right lower region the right inguinal, the central lower 
region the hypogastric, and the left lower region the left 
inguinal. 

The right hypochondriac region contains the right 
lobe of the liver, the gall-bladder, part of the colon, and 
part of the right kidney The right lumber region con¬ 
tains the ascending colon, part of the right kidney, and a 
small portion of the small intestines. The right inguinal 
region contains the caecum (9, Stomach plate), the ureter 
(24, Back plate), and spermatic vessels. The epigastric 
region contains the middle and pyloric end of the stomach, 
the left lobe of the liver, the pancreas (19), the duodenum, 
parts of the kidneys, the supra-renal capsules, the aorta, 
and branches of the vena cava and thoracic duct. The 
umbilical region contains the transverse colon, part of the 
great omentum and mesentery, part of the duodenum 
(5, Stomach Plate), some portions of the jejunum (7), and 
ileum (7), also part of both kidneys. The hypogastric 
region contains the convolutions of the small intestines, 
the bladder if distended, and the uterus during pregnancy. 
The left hypochondriac region contains the splenic end of 
the stomach, the spleen and extremity of the pancreas, 
the splenic flexure of the colon and part of the left kidney. 

t 

The left lumber region contains the descending colon, 
part of the omentum, part of the left kidney and some 
parts of the small intestines. The left inguinal region 
contains the sigmoid flexure of the colon, the ureter, and 
spermatic vessels. 

THE LIVER. 

(See Body Section of Aid.) 

The liver is a glandular organ of very large size, which 
secretes the bile, and effects changes in the blood in its 


passage through the gland. It is situated on the right 
side, in what is known as the right hypochondriac and epi¬ 
gastric regions, and is the largest gland in the body, 
weighing from three and one-half to four pounds; its 
measurements transversely being from ten to twelve 
inches, six to seven inches in thickness, and about three 
inches at the back of the right lobe (i), that being the 
thickest part. Its upper surface is convex, smooth 
and covered by peritoneum; its under surface concave, 
directed downward and backward. Five fissures are seen 
upon the under surface of the liver, named the longitudi¬ 
nal fissure, the fissure of the ductus venoses, the trans¬ 
verse fissure, the fissure for the gall-bladder (3), and the 
fissure for the inferior vena cava. The longitudinal 
fissure is a deep groove, which separates the right lobe of 
the liver from the left; the fissure of the ductus venoses 
is the back part of the longitudinal fissure, and is shorter 
and more shallow than the anterior portion; the trans¬ 
verse, or portal fissure, is short but deep, and years ago 
was supposed to be a gateway of the liver, therefore the 
large vein which enters at this point was called the portal 
vein (4); the fissure for the gall-bladder is shallow and 
oblong, and, placed on the under surface of the right lobe, 
it extends from the anterior free margin of the liver; the 
fissure of the interior vena cava (5) is short and deep, 
almost a complete canal, and extends upward from be¬ 
hind the right extremity of the transverse fissure to the 
posterior border of the liver, where it joins the fissure for 
the ductus venoses. The right lobe of the liver is larger 
than the left, in proportion about six to one, occupies the 
right side almost exclusively, and is separated from the 
left lobe on its upper surface by the longitudinal ligament. 
The left lobe is more flattened than the right, its upper 


192 


surface convex, its undersurface concave, is situated in the 
epigastric region, and rests upon the front of the stomach. 
The vessels connected with the liver, five in number, are 
the hepatic artery (between 7 and 4), the portal vein (4), 
the hepatic vein (smaller 5), the hepatic duct (7), and the 
lymphatic. The substance of the liver is composed of 
lobules held together by an extremely fine areolar tissue, 
the lobules forming the chief of the hepatic substance. 

THE GALL-BLADDER. 

(3. See Plate of Liver in Aid.) 

The gall-bladder, the reservoir for the bile, is pear- 
shaped, and lies on the under surface of the right lobe of 
the liver. It is about four inches in length, one inch in 
breadth, and holds about one ounce. 

THE PANCREAS. 

(See Last Plate of Body in Aid.) 

The pancreas (19), which is a compound gland, anal¬ 
ogous in its structure to the salivary glands, is situated 
across the posterior wall of the abdomen. In shape it is 
transversely oblong and flat, in length about seven inches, 
one inch and a half in breadth, and about three-quarters 
of an inch in thickness. Its weight is from three to four 
ounces. The arteries of the pancreas are derived from 
the splenic (U) and pancreatico-duodenal branches of the 
hepatic (8, Blood Formation) and the superior mesenteric; 
its veins open into the splenic (21, Blood Formation) and 
superior mesenteric veins (22, Blood Formation). 

THE SPLEEN. 

(See Last Plate of Body in Aid.) 

The spleen (18) is an oblong, flattened form, soft, of 
very brittle consistence, of a dark-blue color, and situated 
in the left hypochondriac region. Its external surface is 





PRACTICAL ANATOMY FOR THE EMBALMER. 


A Few of the Parts from a Human Subject in twenty Dissections, showing 
the exact positions of the Arteries, Veins, Nerves and Muscles throughout the human 
body, also the organs of the Thoracic and Abdominal Cavities in their normal places. 



Internalor Long Gaphenous N. 

Femoral V, 
P Femora / A. 

Internal or Long 5aphenou5 V 
Ant. Div. nFObturator N. 

Gracilis M. 


5artariusM. 

5uperFicial Fascia 
Femur 


Deep Fascia 


Vastus Lxternus M 


Cruraus M. 

Deep Fascia 
Great 5 cia tic N. 

PrnFunda Fern oris A. 

Pro Fun da Fern oris V, 


5emi- Ten dm os us M, 

Adductor Lnngus M. 

Post. Div. oFDhturatorN. 
Gemi-membranosus M. 


TRANSVERSE SECTION OF THE LEG IN REGION WHERE THE FEMORAL 

ARTERY IS USUALLY RAISED. 


Copyright, 1903, by H. S. Eckels & Co. 
















































193 


convex, smooth, and in relation with the under surface cn 
the diaphragm, which separates it from the ninth, tenth, 
and eleventh ribs on the left side. The internal surface is 
slightly concave, and, divided by a fissure, is in relation in 
front with the great end of the stomach, below with the 
tail of the pancreas. The upper end is thick and round, 
the lower end is pointed. The spleen is held in position 
by two folds of peritoneum, one connecting it with the 
stomach, the other, the suspensory ligament, with the 
under surface of the diaphragm. Though varying in size, 
the spleen is usually found to be about five inches in 
length, from three to four inches in breadth, about one 
and one-half inches in thickness, its weight being about 
seven ounces. 

THE KIDNEYS. 

(Back Plate of Body in Aid.) 

The kidneys (20) are situated in the back part of the 
abdomen, in the loins, one on each side of the vertebral 
column, resting upon the lower part of the diaphragm, and 
are surrounded by a large quantity of fat and loose tissue. 
Sometimes the kidney, becoming loosened from this vast 
quantity of fat, is only held by the blood-vessels and ureter 
(24), and it is then called a “ floater.” The right kidney 
is usually lower than the left, and is covered in front bythe 
right lobe of the liver, the descending portion of the 
duodenum, and the ascending colon; the left, a trifle 
longer than the right, has in front the fundus of the 
stomach, the tail of the pancreas, and the descending 
colon. In shape the kidney is convex outside or 
posteriorly, and concave on its internal border; it also pre¬ 
sents a pelvis (22) for examination. Each kidney is about 
four inches in length, about two and a half inches in 


194 


breadth, and a trifle more than one inch in thickness; its 
weight varies in the adult male from five to six ounces, in 
the adult female it is about five ounces. The ureters (24), 
two in number, are tubes which conduct the urine from the 
kidneys into the bladder. They are from sixteen to eight¬ 
een inches in length, and in diameter about the size of an 
ordinary goose-quill, and extend from the pelvis (22) of 
the kidney to the bladder. They possess three coats, 
muscular, mucous and fibrous. 

THE BLADDER. 

(See Body Section of Aid.) 

The bladder is a reservoir which contains the urine. It 
is a muscular, membranous sac or pouch, in the male 
situated in the pelvis (22), behind the os pubes and in front 
of the rectum; in the female, between the rectum, the 
uterus and the vagina. It is capable of very great disten¬ 
sion, but in its usual condition measures about five inches 
in length, three inches across, and ordinarily it contains 
about one pint. The structure of the bladder is made up 
of four coats, a serous, a muscular, a sub-mucous and a 
mucous coat. The arteries supplying the bladder are the 
superior, middle, and inferior vesical in the male, the 
female having additional branches from the uterus and 
vagina. The male urethra extends from the neck of the 
bladder to the meatus urinarius, its length varying from 
eight to nine inches, its caliber about three-eighths of an 
inch. It is composed of one continuous mucous mem¬ 
brane, and is supplied with blood from the branches of 
the inferior vesical, the internal iliac, and the dorsal artery. 

r 

THE DIAPHRAGM. 

The diaphragm is a thin, muscular, fibrous septum, 
separating the thorax from the abdomen, forming the floor 


195 


of the thoracic cavity and the roof of the abdominal cavity. 
It is nearly fan-shaped, has three large openings and several 
smaller openings, the former for the passage of the aorta, 
the oesophagus and the vena cava. It is arched, being con¬ 
vex toward the chest and concave to the abdomen, and is 
supplied with blood by the phrenic artery. The diaphragm 
is constantly called into action, as it is the principal muscle 
of respiration. 


CONDUCTING FUNERALS. 

About one hour before the time set for the funeral, repair 
to the house with your assistants, and explain to each the 
duties which you expect him to perform; viz., attending the 
door, directing the relatives to one part of the house and 
friends to another, watching that there be no confusion in 
opening and closing camp-chairs, placing them in position in 
the rooms set part for that purpose, never allowing any to 
remain open in the hallways, receiving flowers at the door, 
and placing them according to directions. See that services 
are begun promptly—delay at such times is a cruelty. One 
assistant should be stationed outside, to attend to the order 
of the carriages. There should be no loud talking in front 
of the house. When everything is in readiness, there should 
be a man at the door to direct the relatives and friends to the 
carriages assigned them ; another at the line of carriages, to 
assist the family and friends to their seats. When all are 
filled a motion of the hand should be given to the one in 
charge. When the cortege moves away, the man left at the 
house should set the home in order before the return of the 
family, removing all evidence of the funeral, carrying his 
paraphernalia to his office, and laying it aside carefully and 
well cleaned for future use. One assistant should return 
from the cemetery, and see to it that the family are assisted 
out of their coaches. Courtesy, gentleness, unobtrusiveness, 
thoughtfulness, sympathy—all are requisite to a proper dis¬ 
charge of Life’s saddest ceremony. 

^ r* 


THE SKELETON. 

* 


Letters and figures inclosed in parentheses, in this Handbook, refer to parts or 
organs similarly lettered or numbered on sections or plates. 


INDEX TO PLATE. 


(1) Frontal. 

(2) Parietal. 

(3) Temporal. 

(4) Mastoid part of Temporal. 


(D) Pisiform. 

(E) Trapezium. 

(F) Trapezoid. 

(G) Os Magnum. 

(H) Unciform. 


(5) Nasal. 

(23) Metacarpus. 

(6) Malar. 

(24) Phalanges. 

(7) Superior Maxillary. 

(25) Sacrum. 

(8) Teeth. 

(26) Coccyx. 

(9) Inferior Maxillary. 

(27) Ilium. 

(10) Cervical Vertebrm. 

(28) Ischium. 

(11) Dorsal Vertebrae. 

(29) Pubes. 

(12) Lumbar Vertebrae. 

(30) Head of Femur. 

(13) Clavicle. 

(31) Neck of Femur. 

(14) Scapula. 

(32) Shaft of Femur. 

(15) Sternum. 

(33) Patella. 

(A) Manubrium. 

(B) Gladiolus. 

(C) Ensiform Appendix. 

(34) Tibia. 

( 35 ) Fibula. 

(36) Tarsus. 

(16) True Ribs. 


(17) False Ribs. 

(18) Floating Ribs. 

(19) Humerus. 

(20) Radius. 

(21) Ulna. 

^22) Carpus. 

(A) Scaphoid. 

(B) Semilunar. 

(C) Cuneiform. 


(37) 

(38) 


(B) Astragalus. 

(C) Scaphoid. 

(D) Head of Astragalus. 

(E) Internal Cuneiform. 
(E) Middle Cuneiform. 
(G) External Cuneiform. 
(II) Cuboid. 

Metatarsus. 

Phalanges. 


196 


197 


THE SKELETON. 

The skeleton consists of two hundred bones, excluding 
those of the ear and the smaller sesamoid bones. The 
sacrum and coccyx, together, have the elements of nine 
vertebrae, but are counted as two bones. The bones give 
outline to the body, and support to the soft parts, form 
cavities for the protection of the important organs, and 
serve as levers and points of attachment for muscles in 
locomotion, and motion of individual parts. 

As to their form, bones are classed as long, short, flat, 
and irregular. 

Long bones have three sources of arterial supply: the 
periosteal vessels for the compact tissue of the shaft; the 
nutrient or medullary artery for the marrow and deeper 
parts of the shaft; the articular arteries for the cancellous 
tissue and red marrow of the extremities. These sets of 
vessels communicate freely with each other. 

In structure, bone tissue is either dense or porous. The 
former is compact tissue , and is found in the shaft of the 
long bones and the surfaces of all bones; the latter is 
cancellous tissue , and forms the expanded ends of the long 
bones, and the central part of other bones. Compact 
tissue is disposed in concentric layers {lamella). Cancellous 
tissue is made by these layers separating, diverging and 
interlacing, the fibers being disposed in the forms of arches, 
which give elasticity and strength. These arches are 
always arranged with reference to points of pressure and 
traction. 

Except where covered with cartilage, bones are sur¬ 
rounded by a dense fibrous membrane, the periosteum , 
which serves as a nidus for the subdivision and distribution 
of arteries to the bone beneath. It sends a sheath with 


each vessel. By its under layer, which is gelatinous and 
contains the osteoblasts, it contributes to the growth, 
nutrition, and repair of bones. 

Histologically, bone consists of bone spaces with their 
contents, and the bone tissue proper. The spaces are the 
medullary cavities , the Haversian canals , the lacunce , and 
the canaliculi. The medullary cavities are the canals of 
long bones which contain yellow marrow (ninety-eight per 
cent, fat), and the medullary cavities of the cancellous 
tissue, which contain red marrow, which substance con¬ 
tributes to the formation of the red blood corpuscles. 
The medullary membrane ( endosteum ) lines these canals 
and spaces. 

The Haversian canals average t- 500th of an inch in 
diameter. The larger ones contain marrow, and all convey 
one or more blood-vessels. The lacunae are characteristic 
of true bone, as distinguished from calcareous deposits. 
They are insect-like cavities between the lamellae, arranged 
in circles around the Haversian canals, oval-shaped, and 
in size 1-2000th by 1-6000th of an inch. Each one 
contains a soft, nucleated substance called a “ bone 
corpuscle.” The canaliculi are the channels by which the 
lacunae communicate with each other and with the 
Haversian canals. Diameter 1-14000th of an inch and 
less. . They contain, each, a minute process of the “ bone 
corpuscle ” of the lacunae. This process imbibes nutrient 
fluid from the blood in the Haversian canals, and passes 
it on from one lacuna or “ bone corpuscle ” to another 
— thus supplying the bone tissue with nutrient material. 

Bone tissue proper, occupies all the space between the 
lacunae and canaliculi. It is one-third organic and two- 
thirds earthy matter. The organic matter makes the 


199 


outline and forms a bed in which the earthy matter is 
laid down as minute osseous granules. 

The embryonic skeleton consists, at first, entirely of this 
animal matrix, for the most part in the form of hyaline 
cartilage. 

Ossification begins by a deposit of bone granules in the 
matrix, at certain points. Each point is a “ center of 
ossification. ’’ These centers are definite in number and 
in their order of succession for each bone, but vary in 
different bones. 

The skeleton begins to ossify in the clavicle, by a 
center which appears the middle of the second month of 
foetal life. 

The primary center in a long bone is for the shaft 
(diaphysis). After the shaft is well advanced in ossifica¬ 
tion, secondary centers (epiphyses) appear in the articular 
ends of the bone. Still later, other centers appear for 
the processes, tuberosities, etc. 

The first epiphysis to appear, and the only one present 
at birth, is that of the lower end of the femur. This fact 
is available in determining certain medico-legal questions 
about premature birth. Soon the diaphysis is separated 
from its epiphyses, only by a thin disc of cartilage 
(epiphyseal cartilage). Eventually, they unite and 
become continuous by ossification of the disc, when the 
individual has attained full stature. This process is com¬ 
pleted in all long bones by the twenty-fifth year. 

Of the epiphyses, that one which appears first unites 
last. The nutrient artery runs toward that epiphysis 
which unites first. The nutrient arteries run toward the 
elbow in the upper extremity, but from the knee in the 
lower limb. 

Bones derive their growth in length from the epiphyseal 

to 


200 


cartilages, but not in equal degree from the upper and 
lower. That epiphysis which appears first — being the one 
from which the nutrient artery runs— contributes most to 
the growth in length. Hence, in the upper extremity, 
the growth in length is derived mostly from the epiphyses 
at the shoulder and wrist, while in the lower limb those at 
the knee contribute most. 

Growth in length is arrested if an epiphyseal cartilage 
is destroyed by suppuration, or prematurely ossified by 
inflammation. The amount of the permanent shortening 
of the limb resulting, will depend on which cartilage is 
involved, and whether its destruction has been complete 
or partial; and if partial, whether on the epiphyseal or 
diaphyseal faces of the cartilage; for that surface of the 
cartilage toward the diaphysis contributes about fifteen 
times more to the growth in length than does the epiphy¬ 
seal face. 

The epiphyseal cartilage, to a certain extent, serves as 
a barrier to the extension of inflammation and suppura¬ 
tion from one part to the other. 

The expanded part of the shaft, between the end of 
the medullary canal and the epiphyseal cartilage, is called 
the juxta-epiphyseal portion (Ollier), and from a patho¬ 
logical and surgical standpoint is the most important part 
of the bone. It is the seat of the greatest physiological 
activity and prolification, and is the zone of election for 
all pathological processes. Also on account of its close 
relation to a joint, and exposed position, it is most liable 
to overstrain, local fatigue, and other slight traumatisms. 
Whence the explanation of the fact that the juxta-epi¬ 
physeal portion of long bones, and to some extent the cor¬ 
responding part of other bones, is much the most frequent 
point of departure for inflammations and development of 


201 


neoplasms during the period of growth. Also at this 
period, that end of the bone which contributes most to its 
growth in length, is the seat of election for neoplasm and 
inflammatory lesions. Hence, the more frequent appear¬ 
ance of benign and malignant growths in the epiphyses at 
the shoulder, wrist and knee, than in those at the elbow, 
hip and ankle. So with all the inflammatory processes, 
tubercular, or other kind. Though, on account of cer¬ 
tain joints being more exposed to traumatisms, the rule is 
not as invariable for inflammatory processes as for neo¬ 
plasms. 


BLOOD 


(1) 

( 2 ) 
( 3 ) 

( 4 ) ( 4 ) ( 4 ) 

( 5 ) ( 5 ) 
( 6 ) 

( 7 ) (8) ( 9 ) 

(io) 

00 

(12) 


FORMATION AND CIRCULATION. 

( Semi-diagrammatic .) 


INDEX TO PLATE. 

ARTERIES. 

Carotid Arteries, which, with the vertebra 1 , 
supply the head. 

Innominate Artery. 

Subclavian. 

Arch of the Aorta—ascending, transverse 
and descending portion. 

Pulmonary Arteries, right and left, contain¬ 
ing venous blood. 

Thoracic Aorta. 

Gastric, Hepatic and Splenic—branches of 
the Cceliac Axis, which is a branch of 

Abdominal Aorta. 

Superior Mesenteric — to small intestines and 
part of large. 

Renal. 



202 


VEINS. 

(13) Vena Cava Superior. 

(14) (14) Innominate — right and left. 

(15) Subclavian. 

(16) Jugular. 

(17) Pulmonary — containing arterial bloodc 

(18) Vena Cava Inferior. 

(19) Hepatic. 

(20) Gastric. 

(21) Splenic. 

(22) Mesenteric. 

(23) Vena Portae. 

(24) Renal (emulgent). 

(25) Right Auricle. 

(26) Left Auricle. 

(27) Right Ventricle. 

(28) Left Ventricle. 

(29) Thoracic Duct. 

VISCERA AND LYMPHATICS. 

(30) Stomach. 

(31) Spleen. 

(32) Liver. 

(33) Kidney. 

(34) Duodenum. 

(35) Ascending Colon. 

(36) Descending Colon. 

(37) Lymphatics of the Intestines—-the vessels 

being called Lacteals;the glands, the Mes¬ 
enteric Glands. 


203 


THE CIRCULATION. 

The greater or Systemic Circulation includes the 
course of the blood from the left auricle (26), through the 
left ventricle (28), arch of the aorta (4), the arteries to the 
upper extremities (3), those to the head(i), thoracic aorta 
(6) and its branches, abdominal aorta (10) with its branches, 
and its continuation and subdivisions for the lower 
extremities; together with the capillaries and veins corre¬ 
sponding to the areas of distribution of the arteries—the 
veins from the head and upper extremities joining to form 
the superior vena cava (13), which opens into the right 
auricle — those from the lower extremities and the pelvic 
and abdominal viscera join to form the inferior vena cava 
(18), which also opens into the right auricle. 

The blood from the intestines and digestive organs 
passes through a second set of capillaries, in the liver, 
before joining the general current in the vena cava. 

The Portal Circulation — a part of the Systemic — in¬ 
cludes the course of the venous blood from all the organs 
of digestion, through the superior and inferior mesenteric 
veins and the splenic and gastric veins, which four trunks 
join to form the portal vein (23). This vein is about four 
inches long, and extends from behind the head of the pan¬ 
creas to the transverse fissure of the liver, where it sub¬ 
divides, and the blood, after passing through a second set 
of capillaries in the liver, leaves it through the hepatic 
veins, and empties into the vena cava inferior. The portal 
system of veins has no valves. 

The lesser or Pulmonic Circulation includes the course 
of the blood from the right auricle (25) through the right 
ventricle (27), through the pulmonary arteries (5, 5), to 
the lungs, and its return through the pulmonary veins (17), 

11 


204 


with a fresh supply of oxygen, to be again distributed 
throughout the system. 

The Lymphatic System is an appendix of the Vascular 
System. Lymphatic vessels begin in the tissues as 
“ lymph spaces ” in connective tissue, as “ perivascular 
spaces,” and as blind tubules within the villi of mucous 
membrane. These spaces, or canals, unite to form tubes 
which unite again and converge to form the thoracic duct 
and the right lymphatic duct. In their course they pass 
through (rather empty into and begin anew) numerous 
lymphatic glands, which are a collection of lymph folli¬ 
cles, and are of the size of a pin head and larger. In 
structure these vessels resemble veins and have many 
valves. The functions of the lymphatic system are, to 
serve as nutrient channels in those tissues devoid of blood¬ 
vessels ; as a drainage apparatus to collect and return to 
the blood fluids which have oozed through the capillaries 
to irrigate the tissues ; and as absorbents and carriers of 
both waste products and food products. The lymphatics 
from the intestines are the lacteals , and during digestion, 
their contents are called chyme. The lymph current is 
from the periphery to the center only. 

The blood is the medium of exchange between the 
outer world and the tissues of the body. It conveys 
tissue building materials from without — food products 
from the 'digestive tract, and oxygen from the lungs. 
The food products are in the form of solutions and emul¬ 
sions, and are absorbed by the veins and lymphatics. 
Their evolution into blood and tissue pabulum is carried 
on while circulating in the vessels and passing through 
the various organs, as the spleen, liver, red marrow of 
bones, etc. The capillaries serve as the ultimate distrib¬ 
uters of the renovated blood to the tissues, which assimi- 


late the new and give up the old. From the intercellu¬ 
lar and lymph spaces, this blood fluid, charged with waste 
products, is then taken up by the veins and lymphatics 
and passed to and through various excretory organs, 
as the lungs, skin, kidneys, liver, etc., which separate the 
effete materials to be cast off. 

The blood makes a complete circuit of the body, on an 
average, in thirty-two or thirty-three seconds, or during 
twenty-seven heart-beats. 

In the adult, the blood constitutes one-thirteenth part 
of the weight of the body; in the new-born infant, one- 
nineteenth. 

Life is endangered by hemorrhage, in proportion to the 
amount and rapidity of the bleeding. In adults, when 
one-half the total blood is lost suddenly, death is liable 
to take place, and in newly born children, when a few 
ounces are lost. The old, the young, and the adipose bear 
the loss of blood badly. 


NERVOUS SYSTEM. 


SPINAL NERVES. 

(A) Cervical Plexus , consisting of first four cervical 

nerves (i), (2), (3), (4). 

(B) Brachial Plexus , consisting of (5) fifth cervical, (6) 

sixth cervical, (7) seventh cervical, ( 8 ) eighth cer¬ 
vical, and (9) first dorsal nerves. 

(10) Second dorsal. (11) Third dorsal. 

(C) Lumbar Plexus, consisting of (12) the first lumbar, 

(13) second lumbar, (14) third lumbar, (15) fourth 
lumbar, and the dorsi-iumbar cord. 



206 


(D) Sacral Plexus, consisting of (16) the fifth lumbar, 

(17) first sacral, (18) second sacral, (19) third 
sacral, and (20) part of fourth sacral. 

(21) Fifth sacral. (22) Coccygeal. 

(a) Phrenic — internal respiratory. 

(b) Long thoracic — external respiratory. 

(c) Spinal Cord. 

(d) Brain. 

(E) Method of communication of Spinal Nerves with 

Sympathetic, by a twig which is composed of 
white matter from the cord to the ganglion and 
gray matter from the ganglion to the cord. 


CRANIAL NERVES. 

(F) Olfactory. 

(G) Optic. 

(H) Motor Oculi. 

(I) Patheticus. 

(J) Tri-facial, (a) Ophthalmic division. (b) Supe¬ 

rior maxillary division. (c) Inferior maxillary 
division, (e, h) Dental branches, (f) Branch 
to palate, (g) Lingual — special nerve of taste to 
tongue. (j) Supraorbital branch of ophthalmic 
division. 

(K) Abducens. 

(L) Portio dura — facial nerve — nerve of expression. 

(The Portio-mollis not shown.) 

(M) Eighth nerve. (m) Glosso-Pharyngeal branch. 

(n) Pneumogastric branch. (p) Spinal Acces- 
sory branch. 

(N) Hypoglossal nerve. 



207 


SYMPATHETIC SYSTEM. 

(I) Cervical portion: (i) Superior, (2) Middle, (3) 
Inferior Cervical Ganglia. 

(II) Thoracic portion. 

(III) Lumbar portion. 

(IV) Sacral portion. 

(V) Ganglion impar. 

The Cephalic portion consists of four pairs of ganglia, 
namely, the ophthalmic, the spheno-palatine, the optic 
and the submaxillary — all in connection with the fifth 
cranial nerve, but communicating freely with the other 
cranial nerves. 

The Sympathetic System has a double chain of ganglia, 
placed on each side of the bodies of the vertebrae. In the 
thorax they lie in front of the heads of the ribs. The 
ganglia correspond mostly with the vertebrae, and the 
divisions of the latter into regions. Each has a branch of 
communication with the spinal nerves — and all with each 
other— composed of white and gray matter. 

These ganglia are th z lateral or vertebral. They give off 
branches which go, chiefly, to the thoracic, abdominal, 
and pelvic cavities, forming the collateral or pre-vertebral 
ganglia, or centers, named the cardiac, the solar, and the 
hypogastric plexuses. From these gangliated plexuses, 
branches are again given off to form the terminal ganglia, 
or plexuses, which surround and accompany all the 
arteries of the viscera. 

The sympathetic has independent functions, due to its 
own gray matter, such as are found in the automatic 
ganglia of the heart, the mesenteric plexus of the intes¬ 
tines, and those for the uterus, ureters, and walls of blood¬ 
vessels. 


208 


The dependent functions of the sympathetic are those 
which inhibit, augment, or modify impulses from the 
cerebro-spinal centers. 


THE SPINAL CORD. 

The spinal cord is that part of the central nervous sys¬ 
tem contained in the spinal canal, extending from the 
foramen magnum to the junction of the first and second 
lumbar vertebrae. It is fifteen to eighteen inches in length, 
and has a cervical and a lumbar enlargement. A median 
fissure, before and behind, divides it into symmetrical 
halves connected by a commissure. The gray matter is 
in the center, in the form of two crescents, placed with 
their convexities together, giving an anterior and a 
posterior horn for each lateral half. Around the gray 
matter, the white conducting matter is disposed as tracts 
or columns, between or through which the anterior and 
posterior roots of the spinal nerves pass to or from the 
horns of the gray matter. 

The spinal cord is, first, a conducting medium; second, 
a center, or centers, for reflex action; third, for automatic 
impulses. It conducts outgoing impulses as motor to 
muscles, vaso-motor to blood-vessels, secretory to glands, 
trophic to the tissues. The paths for the outgoing im¬ 
pulses are, chiefly, the motor tracts from the brain — the 
direct pyramidal in the anterior median part, and the 
crossed pyramidal in the posterior part of the lateral 
columns. Fibers from these tracts pass to and through the 
cells of the anterior horn of each segment to the anterior 
roots of the spinal nerve. Hence the motor tracts diminish 
in size from above downward. It also conducts in-sroin" 
impulses, causin general sensations — cutaneous, articular, 



209 


musculai, visual; special sensations — tactile, pain, heat, 
exciting reflex and automatic centers. These in-going 
impulses come from the periphery—through the poste¬ 
rior roots of the spinal nerves, to and through the cells 
in the posterior horns of the gray matter, and thence up¬ 
ward through the sensory tracts — the posterior median 
and the posterior lateral columns. The sensory tracts 
increase in size from below upward. Impulses are also 
conducted, from one segment to another, through the 
“ association tracts ” — the anterio-lateral column — which 
are of uniform size throughout the cord. 

A center for a spinal reflex is that part of the gray mat¬ 
ter which transfers a stimulus from the in-going fiber of 
the posterior root to the out-going fibers of the anterior 
root, constituting the middle part of the reflex arc. 

The spinal reflexes are the superficial or cutaneous , the 
deep or tendon reflexes and the organic. The cutaneous 
reflexes are the plantar , the cremasteric , the gluteal , the 
abdominal , the epigastric and the interscapular . The 
deep reflexes are the knee-jerk, the jaw jerk, the ankle 
clonus , and the abdominal reflex. The organic reflexes 
are concerned in the acts of respiration, circulation, secre¬ 
tion, micturition, defecation, etc. 

The automatic centers of the cord are those which 
retain their activity after being separated from the 
medulla, but, normally, are subject to the control of the 
higher centers of the medulla and cerebrum, and are sub¬ 
ordinates to these. Examples are the cilio-spinal center 
for dilating the pupil (opposite the lower cervical and the 
upper two dorsal vertebrae); the ano-spinal center in the 
lower lumbar segments; the vesico-spinal about the 
fourth or fifth lumbar; the vaso-motor centers; the sweat 
centers. 


210 


A segment of the spinal cord is that portion of its 
entire thickness which corresponds to the origin of a pair 
of spinal nerves. There are, hence, thirty-one segments, 
each of which has its own special functions as a nerve cen¬ 
ter, and also functions for transmitting and modifying 
impulses from other segments and distant centers. 

Each of the thirty-one pairs of spinal nerves has two 
roots of origin from the cord — a posterior, afferent or sen¬ 
sory root, with a ganglion of gray matter, and an anterior, 
efferent, or motor root. The two roots join at the inter¬ 
vertebral foramen, forming a compound nerve, which then 
separates into an anterior and a posterior division, or ven¬ 
tral and dorsal, each of which has special relations — the 
dorsal supplying the structures about the spinal column. 
They are smaller than the ventral, except those of the first 
and second — the sub-occipital and the great occip’tal — 
which supply the back part of the scalp. 

The ventral divisions supply all the anterior parts of the 
body. Those for the limbs join and intermingle so as to 
form plexuses. The ventral plexus for the upper limb is 
derived from five spinal nerves, while the lumbo-sacral 
plexus for the lower limb is derived from nine. 

As a general rule, a particular nerve trunk supplies 
those parts which are associated in function — as the 
muscles which move a joint (muscular branch), the joint 
itself (articular branch), the skin about the joint and inser¬ 
tion of the muscles (cutaneous branch). 

The roots of the first cervical nerve pass slightly 
upward in the canal to reach the foramen of exit. Those 
of the second pass horizontally, while all others pass down¬ 
ward in the canal to reach the foramen of exit, the spinal 
canal being much larger than the cord. 

The origins of the nerves in the spinal cord have the fol- 


21 I 


lowing relations to the spinous processes of the vertebrae: 

First cervical —level of foramen magnum. 

Second cervical — a little below occipital bone. 

Third cervical— middle of space between occipital bone 
and spinous process of axis. 

Fourth cervical — spine of axis. 

Fifth cervical — spine of third vertebra. 

Sixth cervical — between third and fourth spines. 

Seventh cervical — from spine of fourth to spine of fifth. 

Eighth cervical — below spine of fifth vertebra. 

First dorsal — spine of seventh cervical vertebra. 

Second dorsal— seventh cervical to first dorsal vertebra. 

Third dorsal — first dorsal vertebra and below. 

Fourth dorsal nerve—second dorsal vertebra. 

Fifth dorsal — third dorsal vertebra. 

Sixth dorsal—fourth dorsal vertebra. 

Seventh dorsal — fifth dorsal vertebra and above. 

Eighth dorsal — from fifth to sixth dorsal vertebra. 

Ninth dorsal — from sixth to seventh dorsal vertebra. 

Tenth dorsal — from seventh to eighth dorsal vertebra. 

Eleventh dorsal — from eighth to ninth dorsal vertebra. 

Twelfth dorsal — from ninth to eleventh dorsal vertebra. 

The five lumbar nerves arise from between spines of 
eleventh and twelfth dorsal vertebrae. The five sacral and 
the coccygeal arise from level of the spine of twelfth dorsal 
to first lumbar. The cord terminates at lower border of 
first lumbar vertebra. 

Hence any lesion which paralyzes the neck and upper 
limbs must be above the fifth cervical vertebra. The 
phrenic nerve—apart of the third and fourth — is affected 
only when the lesion is at or above the axis. A lesion at 
the sixth or seventh cervical paralyzes all the intercostal 
muscles; at the third dorsal, all spaces below the third are 


2 12 


affected; at the fifth dorsal, the abdominal walls; at the 
eleventh dorsal, the lumbar and sacral plexuses become 
involved; at the twelfth dorsal, the sacral plexus is 
paralyzed. 


(For the Brain, see description of the Head.) 


THE BODY AND EXTREMITIES. 


INDEXES TO SECTIONS. 

MUSCLES OF THE ANTERIOR PART OF THE BODY. 

(d) Isthmus of the Thyroid gland, covering the upper 
part of the Trachea. 

(i) Clavicle. 

(g) Manubrium of Sternum. 

(h) Central part of Sternum (Gladiolus). 

(i) Coracoid process of Scapula. 

(k) Acromion process. 

( l ) First rib. (m) Second rib. (n) Third rib. 

(o) Fourth rib. (p) Fifth rib. 

(r) Head of Humerus (greater tuberosity). 

(s) Interclavicular ligament. 

(t) Rhomboid ligament. 

(u) Aponeurosis of External Intercostals. 

(V) Acromio-clavicular ligament. 

(w) Coraco-acromial ligament. 

(17) Platysma-Myoides — a cutaneous muscle, the upper 

end of which is one of the muscles of expression. 

(18) Sterno-mastoid (sternal portion). 

(19) Sterno-hyoid. 

(20) Scalenus Anticus. 

(21) Pectoralis Major. 




2 13 


(22) Pectoralis Minor. 

(23) Subclavius. 

(24) Serratus Magnus — interdigitating with (25) External 

Oblique of the abdomen. 

(26) Linea Alba. 

(27) Rectus. (28) Its transverse aponeuroses (Linea 

Transversse). 

(29) Pyramidalis. 

(30) Internal Oblique. 

(31) Poupart’s Ligament, or Crural Arch, composed of 

the thickened lower border of the aponeurosis of 
external oblique. Below it, is the Saphenous 
opening — the outer end of the Femoral canal, 
through which comes Femoral Hernia. 

(32) External boundary (Pillar) and (33) internal bound¬ 

ary (Pillar) of (34) external abdominal ring, which 
is an opening in the aponeurosis of external 
oblique, caused by divergence of its fibers. The 
lower boundary of the ring is the crest of the 
Pubes. 

(35) Internal abdominal ring, the opening in transversalis 

fascia, situated a half-inch above Poupart’s liga¬ 
ment, and midway between spines of the Pubes and 
Ilium. 

(36) Inguinal canal for the spermatic cord, and through 

which oblique inguinal hernia makes its way. It* 
roof is the conjoined lower border of interna; 
oblique and transversalis muscles; its floor, Pou 
part’s ligament; its outer wall, the aponeurosis or 
external oblique; its inner wall, the transversali. 
fascia, upon which the number 36 is placed. 

( 37 ) Border of Deltoid muscle. 


214 


( 38 ) Coraco-Brachialis. 

(39) Short head, and (40) long head, of biceps. 

THE THORAX. 

(5) Clavicle. 

(6) Sternum. (6) Manubrium. (6') Gladiolus. 

(6") Ensiform Cartilage. 

(7) Ribs. 

(8) Costal Cartilages — those of the false ribs — eighth, 

ninth and tenth—join that of the seventh. 

(9) Sterno-Clavicular joint with ligaments, and (9' 

without. 

(10) Costo-Sternal joint with ligament. 

(11) Inter-clavicular notch. 

(12) Internal and (12') External Intercostal muscles—the 

analogues of the oblique muscles of the abdomen. 
The external are aponeurotic from the sternum to 
the ends of the costal cartilages, and both are 
aponeurotic from the angles of ribs to spine. Be¬ 
tween these two muscular planes, in an osteo- 
fibrous canal on the under border of each rib, are 
the intercostal muscles and nerves. 

(13) ( r 3 ) Costal (Parietal) Pleurae. 

MEDIASTINUM AND LUNGS. 

(14) Mediastinum — the space from before backward, 

from sternum to spine, bounded laterally by the 
Pleurae. Nothing but the cellulo-adipose tissue is 
shown. The space is divided into the anterior 
(from the sternum to pericardium), which contains 
the remains of the Thymus gland, Triangularis 
Sterni muscle, left Brachio-Cephalic vein (crossing 
behind first part of sternum), Lymphatic glands 


215 


and left internal Mammary artery and vein ; the 
middle , which contains the heart with its large 
vessels and Phrenic nerves ; and the posterior, con¬ 
taining the CEsophagus, Pneumogastric nerves, 
Aorta, Thoracic Duct, Azygos vein, Trachea and 
Lymphatic glands. 

(15) (15) Upper and lower lobes of left lung. 

(16) (16) (16) Upper, middle and lower lobes of right 

lung. 

INTERIOR OF LUNGS. 

(17) Tracli ea. 

(A) Arch of Aorta. 

(B) Pulmonary artery, which begins in front of root of 

aorta and bifurcates under its arch, giving a branch 
to each lung. It conveys venous blood from the 
right ventricle to the lungs. 

(C) Superior Vena Cava, emptying into right auricle. 

(D) O ne of Left Pulmonary veins, there being two on 

each side which convey the purified blood from the 
lungs to the left auricle, by four openings. 

THE HEART. 

(a) Right Auricle. 

(b) Right Auricular appendage. 

(c) Left Auricle. 

(d) Left Auricular appendage. 

fe) Mitral (Left Auriculo-Ventricular) valve. 

(T) Tricuspid (Right Auriculo-Ventricular) valve. 

(g) Musculi Papillares, with the free ends of which the 
flaps of the valves are connected by (h) the Chordae 
Tendinae. 

(i) Ventricular Septum. 

11 


216 


ABDOMEN AND ABDOMINAL VISCERA. 

(14) Loop of large intestine (Sigmoid Flexure of Colon). 

(15) Bladder. 

(16, to the left.) Great Omentum with Omental vessels, 
branches of the Gastric. 

(16, to the right.) Transversalis fascia and subperitoneal 
fat, in which are imbedded (C ) the deep epigastric 
vessels — the artery, a branch of the external iliac, 
passing upward and inward to reach the sheath of the 
rectus muscle, in which it passes upward to anasto¬ 
mose with the superior epigastric, the terminal 
branch of the internal mammary. In obstruction of 
the abdominal or thoracic aorta, collateral circula¬ 
tion is carried on largely by this circuit. The veins 
(the inner one the larger) passing down, join the 
external iliac. 

(17) Fold of Peritoneum — Median Vesical ligament. (a2) 
Parietal Peritoneum. 

(X) Spermatic artery and vein. 

THE LIVER. 

(1) Right lobe — lower surface. 

(2) Left lobe. 

(3) Gall-bladder distended, which normally projects from 

under the ninth costal cartilage. When distended, 
and the liver is enlarged, it approaches the 
umbilicus. 

(4) Portal vein subdividing. 

(5) Hepatic veins uniting to join the vena cava as it lies 

in its groove on posterior border of liver. 

(< 5 ) Common bile duct, between which and the Portal 
vein, is the Hepatic artery — a branch of the Cceliac 
axis. 


\ 


217 


««;.) Hepatic duct, joining (8) the Cystic duct, to make the 
common duct. 

(9) Neck of gall-bladder. 

(10) Cystic artery. 

(1 1) The Round ligament — the remains of the umbilical 
artery, lying in the longitudinal fissure between the 
double fold of peritoneum (12), called the Falciform 
or Suspensory ligament. 

STOMACH AND INTESTINES. 

(1') CEsophageal opening of stomach. 

(3) Cardiac end of stomach and interior wall. 

(3') Rugae of mucous membrane. 

(4) Pylorus. 

( 5 ) Beginning of Duodenum. 

( 7 ) Jejunum and Ileum. 

(8) Vermiform Appendix. 

(9) Caecum (Caput Coli). 

(10) Ascending Colon. 

(11) Hepatic Flexure. 

(12) Transverse Colon. 

(13) Splenic Flexure. 

(14) Descending Colon, terminating in the Sigmoid 

Flexure. 

(15) Bladder distended. 

* 

SECTION OF BODY, AND SHOULDER AND HIP JOINTS. 

(1) Superior Constrictor muscle of Pharynx. 

(2) Middle. 

(3) Inferior. 

(4) Mucous membrane of Pharynx. 

(5) Clavicle. 

( 6 ) Acromio-Clavicular ligament. 


( 7 ) Ribs. 

(8) Acromion process of Scapula. 

( 9 ) Coraco-acromial ligament. 

(10) Tendon of long head of Biceps. 

(11) Capsular ligament. 

(12) Anterior or inner surface of external Interco«ta\ 

muscles. 

% 

(12') Internal surface of internal Intercostals. 

(13) Scapula. 

(14) Head of Humerus, the lesser tuberosity of which 

looks directly forward. 

(15') Surgical neck of Humerus, which extends from 
tuberosities to lower border of axilla. 

(16) Coracoid process of Scapula. 

(17) Articular Cartilages of head of Humerus and 

Glenoid Fossa. 

(18) Spleen. 

(19) Pancreas. 

(20) Right kidney. 

(20') Pyramidal substance of kidney. 

(21) Supra-renal Capsule. 

(22) Pelvis. 

(22') Calyces. 

(23) Cortical substance. 

(24) Ureter. 

(25) Transversalis muscle. 

(26) Psoas. 

(27) Iliacus Internus. 

(28) Pyriformis, the anterior border being continuous with 

the Coccygeus, forming the floor of the Pelvis. 

(29) Sacrum. 

(30) Sacro-Iliac ligament. 


2 19 

(31) Capsular ligament of hip joint. It is re-enforced, on 
the anterior surface, by (32) the inverted “ Y ” or 
Ilio-Femoral ligament, whicharises from the anterior- 
inferior spine of Ilium, and is inserted into (33) the 
intertrochanteric line of Femur. 

(34) Outer surface Great Trochanter. 

(35) Tuberosity of Ischium. 

(36) Anterior pubic ligament. 

( 37 ) Obturator membrane. 

(38) Pectineal eminence. 

( 39 ) Crest of Ilium, ending below in the anterior superior 

spine. 

(40) Section of rim of Acetabulum, and articular cartilage. 

(41) Synovial sac of hip joint. 

(42) Lesser Trochanter. 

(A) Aorta. 

(E) Inferior Vena Cava. 

(F) Right and left common Iliac arteries. 

(F') Internal Iliac. 

(F' x ) External Iliac. 

(G) Left common Iliac vein. 

(G) Left external Iliac vein. 

(H) Common Femoral artery. 

(IT) Superficial Femoral. 

(FI") Deep Femoral. 

(1) Right Azygos vein, which takes the place of the 
vena cava within the chest, receiving all the right 
intercostal veins, and, after arching over the right 
bronchus, empties into the superior vena cava. It 
communicates with the inferior cava at its beginning, 
either directly or indirectly. It is joined by the left 
azygos about the middle of the chest. 


12 


220 


(k) Subclavian artery, terminating at the lower border 
of the first rib, in the axillary, which terminates in 
(i) the brachial, at the lower border of the teres 
major muscle. 

(m) Acrominal Thoracic. 

(n, n') Short and Long Thoracic. 

(o) Subscapular — giving off dorsalis scapulae. 

(p) Anterior and (q) Posterior Circumflex. 

(r) Superior Profunda. 

(s) Branches of Transversalis Colli. 

(t) Intercostal arteries and veins. 

(u) Splenic artery. 

(v) Renal artery. 

(v') Lumbar artery. 

(w) Renal vein. 

(x) Spermatic artery and vein. 

(y) Inferior Mesenteric. 

(a') Lumbar artery and vein. 

(b') Superior Gluteal. 

(b2) Ilio-lumbar. 

(c') Deep Epigastric. 

(d') Circumflex Iliac. 

(e') Sciatic and Internal Pudic. 

(f) External Circumflex. 

(g') Obturator. 

UPPER EXTREMITY. 

PLATE 1. 

Arm. — (i) Acromion process. (12) Fascia of pectoralis 
muscle. (13) Deep fascia of arm. (18) Deltoid muscle 
covered with fascia. (19) Pectoralis major muscle. No 
arteries except small muscular (B) or cutaneous branches 
are shown. (I) Subcutaneous veins. (II) Basilic vein. 


221 


(Hi) Cephalic vein. (IV) Median and median cephalic 
veins, (a) Supraclavicular nerve, (b) Posterior cutane¬ 
ous, from the circumflex, (c) Branches from the anterior 
thoracic, (d) Internal cutaneous, (e) Lesser internal 
cutaneous, (h) Musculo-cutaneous. 

Fore-arm and Hand. —(9) Deep fascia. (10) Bicipital 
fascia. (11) Palmar fascia. (11') Transverse palmar 
ligament. (12) Anterior annular ligament. (14) Panic- 
ulus adiposus of the fingers. (29) Palmaris brevis muscle. 
(Ill) Cephalic or radial vein. (IV) Median vein. (V) 
Median Basilic vein, (a) Branches of internal cutaneous 
nerve (b) Same, (c) Branches of musculo-cutaneous 
nerve, (i) Palmar branch of ulnar nerve, (m) External 
cutaneous branch from musculo-spinal nerve. 

PI,ATE 2 . 

Arm. —(1) Acromial end of clavicle. (2) Coracoid pro¬ 
cess of scapula. (3) Greater tuberosity of head of 
humerus. (4) Lesser. (5) Bicipital groove. (8) Coraco- 
clavicular ligament. (9) Coraco-acromial ligament. (10) 
Capsular ligament. (1 5) Bicipital fascia. (16) Pectoralis 
major tendon. (17) Triceps muscle. (19) Pectoralis 
major. (20) Biceps. (20 ) Short head of biceps. (20") 
Lo ng head of biceps. (21) Coraco-brachialis muscle. 
(22) Brachialis anticus muscle. (23) Triceps muscle. (A) 
Brachial artery. (D) Inferior profunda. (Ill) Cephalic 
vein. (IV) Median Cephalic. (V) Venae comites — 
brachial. (VI) Beginning of Cephalic. 

Fore-arm and Hand. — (1) Internal condyle of humerus. 
(9) Deep fascia. (10) Aponeurosis of biceps muscle. 
(11) Palmar fascia. (12) Anterior annular ligament. (13) 
Sheaths of flexor tendons — circular and oblique fibers. 
(1 5) Biceps muscle. (1 5) Inferior bicipital tendon. (16) 


222 


Brachialis anticus muscle. (17) Triceps. (18) Supinator 
longus. (22) Flexor carpi radialis. (23) Palmaris longus. 
(24) Flexor sublimis digitorum. (27) Flexor carpi ulnaris. 
(28) Pronator quadratus. (29) Palmaris brevis. (30; 
Abductor pollicis. (31) Opponens pollicis. (32) 
Flexor brevis pollicis. (73) Adductor pollicis. (34) 
Abductor minimi digiti. (35) Flexor brevis minimi 
digiti. (36) Lumbricales. (B) Radial artery. (G) Ulnar 
artery, forming the superficial palmar arch. (K) Digital 
branches. (N) Superficial radial nerve. (N'') Dorsal 
branch. 

PLATE 


Arm. — (1) Acromio-clavicular joint. (2) Coracoid pro¬ 
cess. (3) Greater tuberosity of head of humerus. (4) Lesser. 
(1 1) Sheath of biceps tendon. (16) Insertion of pectoralis 
major muscle. (17) Insertion of deltoid. (18) Deltoid. 
(20') Long head of biceps. (20") Short head. (21) 
Coraco-brachialis. (22) Brachialis anticus. (23) Triceps. 
(A) Brachial artery. (B) Muscular branches. (C) 
Superior profunda. (D) Inferior profunda, (d) Internal 
cutaneous nerve, (f) Median nerve, (g) Ulnar. (h) 
Musculo-cutaneous. 

Fore-arm and Hand .— (1) Internal condyle. (2) Radius. 
(3) Ulnar. (4) Pisiform bone. (5) Unciform bone. (6) 
First phalanges. (7) Second. (8) Third phalanges. (15) 
Biceps tendon. (16) Brachialis anticus. (19) Extensor 
carpi radialis brevior. (20) Supinator brevis. (24) Flexor 
sublimis digitorum. (26) Flexor longus pollicis. (28) 
Pronator quadratus. (31) Opponens pollicis. (32) Flexor 
brevis pollicis. (33) Adductor pollicis. (34) Abductor 
minimi digiti. (35) Flexor brevis minimi digiti. (37) 
Interossei. (A) Brachial artery. (B) Radial. (C) 
Superficial volar branch. (D) Dorsal branch. (E) Ulnar 


223 


artery. (F) Interosseous. (G) Superficial branch for 
superficial palmar arch. (K) Digital branches. (V) 
Venae comites. (d) Median nerve, (d ) Muscular branch, 
(e) Internal interosseous. (g) Digital branches, (k) 
Ulnar nerve, (k, k) Digital and muscular branches. ( 1 ) 
Radial nerve, (n) Superficial radial, (n') Anterior, (n") 
Posterior branches. 


PLATE 4. 

Arm. —(2) Acromion process. (2 ) Coracoid process. 
(3) Clavicle. (4) Greater tuberosity. (11) Capsular 
ligament. (12) Sheath of biceps tendon. (20) Long 
head of biceps. (24) Internal head of triceps muscle. 
(24 / ) External head of triceps. (24"') Middle or scapu¬ 
lar head of triceps. (A) Axillary artery. (B) Brachial 
artery. (C ) Acromial branch of transverse scapular 
artery. (D) Thoracic branch of brachial artery. (E) 
Acromial thoracic. (F) Long thoracic branch. (G, G') 
Subscapular artery and branches. (H) Anterior circum¬ 
flex. (I) Posterior circumflex. (K) Muscular branches. 
(L) Superior profunda. (M) Inferior profunda. 

Fore-arm and Hand. —(16) Anterior ligament, elbow 
joint. (18) External lateral ligament. (18') Part of 
orbicular ligament. (20) Interosseous ligament. (5) 
Styloid process of ulna. (7) Styloid process of radius. 
(8) Pisiform bone. (9) Unciform bone. (10) Trapezium. 
(11) Carpo-metacarpal joint of thumb. (12) Metacar¬ 
pal. (13) First phalanges. (14) Second phalanges. 
(15) Third phalanges. (16, 18, 18 ) Ligaments of elbow 
joint. (31) Pronator radii teres. (32) Supinator brevis 
muscle. (33) Flexor carpi radialis. (34) Pulmonis 
longus. (35) Flexor sublimis digitorum. (36) Plexor 
profundis digitorum. (37) Flexor longus pollicis. (38) 


224 


Pronator quadratus. (39) Adductor pollicis. (40) Ab¬ 
ductor minimi digiti. (41) Palmar interosseous. (B) 
Radial artery. (D) Dorsalis pollicis. (G) Ulnar. (G) 
Ulnar recurrent. (H) Interosseous. (I) Metacarpal 
branch. (K) Termination of ulnar, which is continued as 
the superficial palmar arch. 

PLATE 5. 

Arm .— (2) Acromion. (3) Clavicle. (22) Coracoid 
process. (4) Greater tuberosity of the head of humerus. 
(12) Sheath of biceps tendon. (19) Insertion of pectoralis 
major. (20) Biceps tendon, long head. (21) Short 
head. (22) Coraco-brachialis. (23) Brachialis anticus. 
(24) Triceps muscle. (A) Axillary artery. (B) Brachial. 
(F) Long thoracic. (G, G) Subscapular and its branches. 
(H) Anterior circumflex. (I) Posterior circumflex. (K) 
Muscular branches. (L) Superior profunda. (M) In¬ 
ferior profunda. (N) Anastomotica magna. 

Fore-arm and Hand .— (2) External condyle of humerus. 
(4) Ulna (6) Radius. (7) Styloid process of radius. 
(8) Pisiform bone. (9) Unciform. (1 o) Trapezium. (11) 
Trapezoid. (12) Metacarpal. (13, 14) Phalanges of 
thumb. (16) Anterior ligaments. (20) Interosseous liga¬ 
ments of elbow joint. (22, 23, 24) Ligaments of wrist 
joint. (30) Tendon of biceps — insertion. (31) Pronator 
radii teres. (32) Supinator brevis. (36) Tendons of 
flexor sublimis digitorum. (38) Pronator quadratus. 
(41) Interosseous. (A) Brachial artery, lower end. (B) 
Radial artery. (C) Superficialis volax (D) Dorsal branch 
of radial. (D\ D") Dorsal branches to thumb. (E) First 
digital branch. (E', E") Branches to ulnar and radial 
sides of thumb (princeps pollicis). (I 7 ) Deep palmar 
branch. (G) Ulnar artery. (G') Ulnar recurrent interos- 


225 


seous. (IT) Anterior interosseous. (I) Dorsal branch. 
(K) Ulnar, dividing into deep and superficial branches; 
the superficial joining (C) to form (K) the superficial 
palmar arch — the deep branch joining from the radial 
to form (L ) the deep palmar arch. (M) Digital branch 
to little finger. (N) Common digital branches. (O) Interos¬ 
seous arteries. (P) Digital. 

PLATE 6. 

Ann .— (2) Coracoid process. (3) Clavicle. (4) Greater 
tuberosity of humerus. (9) Coraco-clavicular ligament. 
(10) Coraco-acromial. (11) Capsular ligament. (12) 
Sheath of biceps tendon. (16) Anterior ligament of elbow 
joint. (17, 18) Lateral ligaments. (20) Long tendon of 
biceps. (18') Orbicular ligament. (A) Position of axil¬ 
lary artery. (D) Long thoracic. (E) Anterior thoracic. 

(F) Subscapular. (G) Internal cutaneous of arm (G') 

Posterior branch. (H) Middle cutaneous. (H') Ulnar 

cutaneous branch. (I) Musculo-cutaneous nerve. (K) 

Circumflex. (L) Posterior cutaneous of arm. (M) Median 
nerve. (N) Ulnar nerve. (O) Muscular spiral. (O') 
External cutaneous branch. 

Fore-arm and Hand .— (1) Internal condyle of humerus. 
(2) External. (3) Internal part of trochlear surface of 
humerus. (4) Ulna. (5) Styloid process. (6) Radius. 
(6') Neck of radius. (6' ; ) Bicipital tuberosity. (7) Sty¬ 
loid process of radius. (8) Pisiform bone. (9) Unciform 
bone. (10) Scaphoid. (11) Trapezium. (12) Meta¬ 
carpus. (13, 14, 1 5) Phalanges. (19) Oblique ligament. 
(20) Interosseous membrane. (21, 24) Straight and 
oblique volar ligaments. (22, 23) Lateral ligaments. 
(25, 26) Anterior carpal ligaments. (27, 28, 29, 30) 
Carpal, metacarpal and transverse ligaments, (a) Lesser 


226 


internal cutaneous nerve, (b 7 ) Palmar branch, (b ") Ulnar 
cutaneous branches, (c) Musculo cutaneous, (d) Median 
nerve, (d') Muscular branches, (e) Interosseous branch, 
(f) Long palmar, (g) Digital branches, (h) Ulnar nerve, 
(i) Dorsal branch. (k) Palmar branch, (k ) Superficial 
palmar branch, (k") Digital branches, (k 77 ') Deep ulnar 
branch. ( 1 ) Radial. ( 1 ) External cutaneous branch, 
(m) Posterior branch, (n) Anterior, (n') Dorsal branch 
of thumb 


LOWER EXTREMITY. 


PLATE 1. 


Thigh .— (i) Patella. (5) Fascia lata. (6) Crural fascia. 
(8) Bursa patellae. (I) Internal saphenous vein. (II) 
Subcutaneous veins, (a) External cutaneous nerve, (b) 
Branch of genito-crural nerve, (c) Branch of inguinal, 
(e) Internal cutaneous nerve, (f) Middle cutaneous. 

Leg .— (2) Internal malleolus. (4) External malleolus. 
(6) Deep fascia of the leg. (7) Anterior annular liga¬ 
ment. (8) Dorsal fascia of the foot. (I) Subcutaneous 
veins. (II) Long saphenous vein, (a) Long saphenous 
nerve, (b) Musculo-cutaneous. (c) Cutaneous branches 
of external popliteal, (d) Internal cutaneous of the dor¬ 
sum of foot. (e) Middle cutaneous of dorsum. (g) 
Digital nerves. 


PLATE 3. 

Thigh .— (1) Patella. (2) Internal condyle of femur, 
(3) of tibia. (9) Sartorius muscle. (10) Rectus muscle. 
(11) Vastus internus. (12) Vastus externus. (14) Pec- 
tineus muscle. (15) Adductor longus. (17) Gracilis. 
(I) Long saphenous vein. (II) Subcutaneous veins, (e) 
Branches of internal cutaneous nerve. 


22 7 


Leg .—(0 Tibia. (2) Internal malleolus. (3) Fibula. 
(4) External malleolus. (5) Metatarsal. (7) Anterior 
annular ligament. (9) Tibialis anticus. (10) Extensor 
digitorum longus. (10') Peroneus tertius. (11) Exten¬ 
sor brevis digitorum. (14) Extensor hallucis longus. 
(13) Peroneus longus. (14) Peroneus brevis. (15) Gas¬ 
trocnemius. (16) Soleus. (17) Abductor hallucis. (18) 
Interosseous. (A) Anterior tibial artery. (A') Dor¬ 
salis pedis artery. (Ill) Deep veins of leg. 

PliATE 3. 

Thigh .— (1) Patella. (2) Internal condyle of femur. 
(3) Of tibia (5) Deep fascia. (9) Sartorius muscle. 
(io) Rectus muscle. (11) Vastus internus. (12) 
Vastus externus. (13) Psoas and internal iliac mus¬ 
cles. (14) Pectineus. (1 5) Adductor longus. (16) Ad¬ 
ductor magnus. (17) Gracilis. (A) Femoral artery. 
(B) Deep femoral. (C) Muscular branches. (I) Internal 
saphenous vein, (c) Branch of ilio-inguinal nerve, (e) 
Branches of internal cutaneous, (f) Middle cutaneous, 
(g) Saphenous branches. (h) Muscular branches of 
crural nerve, (i) Musculo-cutaneous branches of crural 
nerve. 

Leg .— (1) Tibia. (2) Internal malleolus. (4) Externa 
malleolus. (5) Metatarsal bones. (6) Fascia. (7) An¬ 
terior annular ligament. (9) Tibialis anticus tendon. 
(10) Extensor longus digitorum. (11) Extensor brevis 
digitorum. (12) Extensor hallucis longus. (13) Pero¬ 
neus longus. (14) Peroneus brevis. (15) Gastrocnemius. 
(16) Soleus. (17) Abductor hallucis. (18) Interosseous, 
(b) Musculo-cutaneous nerves. (d) Dorsal cutaneous of 
foot. (e) Middle dorsal cutaneous, (f) Terminal branch 
of external saphenous, (g) Digital branches. (h; An- 


228 


terior tibial. (IV) Internal. (h") Internal branches of 
same. 

PLATE 4. 

Thigh .— (i) Femur. (2) Internal Condyle. (3) 
External Condyle. (4) Patella. (13) Gracilis mus¬ 
cle. (14) Adductor longus muscle. (15) Ad¬ 
ductor brevis. (16) Adductor magnus. (17) Insertion of 
pectineus muscle. (A) Femoral artery. (B) Deep femo¬ 
ral. (D')First perforating artery. (F) Muscular branches. 
(5) Tuberosity of tibia. (7) Ligamentum patellae (middle 
part). (8) Internal lateral part. (9) Internal lateral liga¬ 
ment. (10) External lateral ligament (anterior part), 
(ic/) Posterior part. (11) Synovial capsule. 

Leg and Foot .— (1) Tibia. (2) Internal malleolus. 
(3) Fibula. (4) External malleolus. (5) Tarsus. (6) 
Metatarsus. (7) First phalanges. (8) Second phalanges. 
(9) Anterior annular ligament. (10) Interosseous mem¬ 
brane. (10') Tibio-fibular ligament. (10") Superior ex¬ 
ternal malleolar ligament. (11) Internal lateral or deltoid 
ligament. (13) External lateral ligament (anterior part). 
(14) Transverse metatarsal ligaments. (15) Capsular and 
lateral ligaments. (16) Peroneus longus and brevis mus¬ 
cles. (17) Tendons of extensor longus digitorum muscle, 
(18) of extensor longus pollicis, (19) of tibialis anticus. 
(20) Dorsal interosseous muscle. (A) Anterior tibial. 
(A ) Dorsalis pedis. 

PLATE 5. 

Thigh .— (1) Femur. (2) Internal condyle. (3) Ex¬ 
ternal condyle. (4) Patella. (7) Ligamentum patellae. 
(8) Lateral ligament of patella. (9) Internal lateral liga¬ 
ment of knee joint. (10) External lateral ligament 
(anterior part). (10') Posterior part. (11) Synovial cap 
sule. (16) Adductor magnus. (17) Insertion of pecti- 


229 


neus muscle. (A) Femoral artery. (B) Profunda femoris. 

(C) Descending branch of external circumflex artery. 
(D ) First perforating. (D") Second perforating. (D") 
Ihird perforating. (E) Nutrient artery of femur. (F) 
Muscular branches. (G) Anastomotica magna. (H) 
Popliteal. (I) Muscular branches. (K) Superior exter¬ 
nal auricular. (L) Superior internal auricular. (M) Mid¬ 
dle articular. (N) Sural branches. (O) Inferior exter¬ 
nal articular. (P) Inferior internal articular branches. 
(Q) Anterior tibial. 

Leg and Foot. —(i) Tibia. (2) Internal. (3) Exter¬ 
nal malleolus. (4) Fibula. (5) Tarsus. (6) Metatarsus. 
(7) First phalanges. (8) Second phalanges. (10) Inter¬ 
osseous membrane. (10') Tibio-fibular ligament. (10") 
Superior external malleolar ligament. (11) Internal lat¬ 
eral or deltoid ligament. (12) Astragalo-scaphoid. (13) 
Anterior external lateral. (13') Middle external lateral. 
(14) Transverse metatarsal. (15) Capsular ligaments. 
(A) Anterior tibial artery. (A') Dorsalis pedis. (B) Re¬ 
current tibial. (C) External malleolar. (C) Internal. 

(D) External tarsal. (D') Internal tarsal. (D ") Anterior 
tarsal. (E) Metatarsal. (F) Dorsal interosseous. (F') 
Dorsalis hallucis. (F' 7 ) Deep plantar branch of same. 
(G) Posterior tibial. (H) Peroneal. (IT) Anterior per¬ 
oneal. (K) Posterior internal malleolar. (K 7 ) Posterior 
external. (L) Internal plantar. (L 7 ) Internal superficial 
branch. (M) External plantar. (N) Superior plantar 
arch. (O) Sural branch. 

PLATE G. 

Thigh .— (1) Femur. (2,3) Internal and external con¬ 
dyles. (4) Patella. (5') Tuberosity of tibia. (6) Head 
of fibula. (7) Li gamentum patellae. (8) Internal lateral 


part. (9) Internal lateral ligament of knee. (10, io') 
External lateral ligament. (11) Synovial capsule, (a) 
Anterior obturator nerve, (b) Internal cutaneous, (c) 
Anterior internal cutaneous, (d) Long saphenous, (e) 
Great sciatic, (f) External popliteal or peroneal, (f') 
Posterior cutaneous branches of leg. (i) Internal popli¬ 
teal nerve, (k) Sural or long cutaneous nerve. ( 1 ) 
Anterior external cutaneous. 

Leg and Foot .—(Figures refer to same as in preceding 
plate). — (a) Long saphenous nerve, (b) Musculocuta¬ 
neous or superficial peroneal, (c) Anterior cutaneous 
branches, (d) Internal cutaneous branch of foot, (e) 
Middle cutaneous branch, (f) Posterior external cuta¬ 
neous of leg. (g) Digital branches, (h) Anterior tibial. 
(h') Internal branch, (h 7 ) External branch, (i) Pos¬ 
terior tibial. (k) External saphenous branch. (k') 
External cutaneous branch. ( 1 ) Internal plantar, (m) 
External plantar, (n) Digital plantar. 


THE HEAD. 


THE SKULL, SCALP, ETC. 

The skull, the bony part of the head, consists of the 
cranium and the face. Eight bones compose the former, 
and fourteen the latter. The immovable joints of the 
skull are called sutures (5), of which those of the vertex 
are the most important. These sutures are best named 
anatomically, as the fronto-parietal ( coronal ), the inter¬ 
parietal [sagittal), occipito-parietal ( lambdoid ). The 
average thickness of the flat bones of the cranium is one- 
fifth of an inch. The thickest parts are the occipital pro¬ 
tuberance and at the parietal and frontal eminences. 
The temporal region is the thinnest. These flat bones 
have some peculiarities. The outer layer of “ compact 
tissue” (external table) is thick and tough; the inner 
(internal table), thin and brittle. The cancellous tissue 
(diploe), most marked in middle life, is “ intermediate like 
a soft leather cushion,” and is channeled for numerous 
large veins with thin walls. The frontal, and part of the 
temporal groups of the diploic veins, discharge into the 
external veins of the head, while the occipital, and part 
of the temporal, discharge into the sinuses of the dura- 
mater; thus affording collateral relief for obstructed cir¬ 
culation of the brain by the intercommunication of the 
internal and external venous systems. This relation 
explains the serious brain symptoms which are liable to 
follow even a slight septic inflammation of the scalp and 
lesions of the cranial bones. Great vascularity charac¬ 
terizes the bones of the cranium and face, as well as all 

231 



the soft parts connected with them; hence the relatively 
quicker and more certain repair of injuries, or wounds. 

There are three kinds of sinuses: Those of the dura 
mater for the return of the venous blood from the brain; 
the cerebral sinuses, which are interspaces between its 
lateral halves or other parts; and those in the bone, as 
the frontal, sphenoidal, etc., which contain air and com¬ 
municate with the air passages. 

There are five distinct strata of tissues covering the 
cranium; I. The skin. 2. Dense fibro-adipose tissue, 
in which are the hair bulbs and the cutaneous vessels and 
nerves. The arteries, adhering to and firmly embedded 
in this tissue, when cut, do not contract or retract, and 
are with difficulty seized and drawn out with forceps; 
hence the free hemorrhage in scalp wounds and the 
trouble in arresting it. 3. The occipito-frontalis muscle, 
with its aponeurosis, which gives power to move the scalp, 
and which is, like the facial muscles, supplied by the 
facial nerve, and is classed as one of the muscles of ex¬ 
pression. These three structures constitute the scalp , as 
the term is commonly used. 4. Loose areolar tissue, 
without fat, which allows “ scalp ” to glide freely on 
5. The pericranium (external periosteum). 

The remarkable vitality of the flaps in extensive wounds 
of the scalp is due not more to the free arterial supply 
and anastomosis than to the fact that the arteries are 
carried with the flap entering it from its base. 

Cephalaematoma is a blood tumor between the peri¬ 
cranium and the bone, and is limited to one bone. The 
ordinary effusion of blood (haematoma), as from a bruise, 
is in the loose areolar tissue between the aponeurosis and 
the pericranium. It is liable to be diffuse, but is not often 
large, because the vessels in this tissue are small. Wounds 


233 


of the scalp are not more prone to erysipelatous inflamma¬ 
tion than other wounds. But phlegmonous inflamma¬ 
tion (erroneously called erysipelas) does often occur if 
the wound is not properly treated. The loose areolar 
tissue is a favorable nidus for sepsis. The skin heals 
rapidly and confines septic secretions beneath, which 
diffuse rapidly. Drainage, keeping the angles of the 
wound open, and compression are most important in 
scalp wounds. 

(1) Frontal bone 

(2) Parietal. 

(3) Occipital. 

(4) Squamous portion of Temporal. 

( 5 , 5 ) Fronto-parietal (Coronal) and Occipito-parietal 
(Lambdoid) sutures 

(6) Malar. 

(7) External Auditory Meatus. 

(8) Orbicularis Palpebrarum muscle. 

(9, 9) Zygomatici Major and Minor 

(10) Masseter muscle. 

(11) Orbicularis Oris. 

(12) Levator Menti. 

(13) Sterno-mastoid. 

(14) Levator Anguli Scapulae. 

(15) Omo-hyoid — anterior part 

(16) Internal Jugular vein. 

(17) P'acial vein. 

(18) Temporal vein. 

(19) Common Carotid artery. 

(20) Facial artery. 

(21) Superficial Cervical nerves 

(22) Facial nerve. 

(23) Supra-maxillary division. 


(24) 

(25) 

( 26 ) 

(27) 

( 28 ) 

(29) 

(30) 

(31) 

(32) 

(33) 

(34) 

(35) 

(36) 

(37) 

(38) 
(39, 40 ) 

(40 

(42) 

(43) 

(44) 

(45) 
(46, 47) 


(48) 

(49) 

(50) 
(50 


Trachea. 

Scalp. 

Skull. 

Cerebrum. 

Cerebellum. 

Spinal cord. 

Medulla Oblongata. 

Eyeball. 

Internal Rectus muscle. 

Optic nerve. 

Internal surface of Malar bone. 

Inferior Maxillary. 

Anterior Naris. 

Inferior Dental artery, and 
Nerve. 

Cortex of Cerebrum, showing convolutions of 
gray matter. 

Corpus Callosum. 

Corpus Striatum. 

Optic Thalamus. 

Section of Cerebellum. 

Medulla Oblongata. 

Outer wall of nasal cavity, showing the three 
turbinated bones and the meatuses — superior, 
middle and inferior—and the distribution of 
the olfactory nerve, 

The Hard palate — formed in front by the superior 
maxillary, and behind by the palate. 

Pharyngeal opening of Eustachian tube. 
Pharynx. 

Soft palate. 


(52) Lateral portion of roof of mouth. 

( 53 ) Tongue. 

(54) Sublingual gland. 

( 55 ) Epiglottis. 

(56) Larynx. 

(57) Junction of pharynx and oesophagus. This 

point is opposite the body of the fifth cervical 
vertebra (its lower border) and corresponds 
with junction of larynx and trachea. 

(58) Body of fifth cervical vertebra. 

(58 ) Spinal process of vertebra. 


THE BRAIN. 

The gray matter of the brain is disposed as a layer on 
the outer surface — the cortex with its convolutions; as 
circumscribed convolutions in the basal ganglia — corpus 
striatum, optic thalamus, corpora quadrigemina; or, as 
the central gray tube continued up from the spinal chord 
through the medulla and pons around the iter to the tuber 
cinereum. The white matter connects these parts in vari¬ 
ous ways — either longitudinally or transversely — the 
corona radiata (1), (2), (3), (4), connecting the cortex 
with the basal ganglia; the commissural fibers (c, c) con¬ 
necting corresponding parts of the two hemispheres; the 
association fibers (a, a) connecting different areas of the 
same part; the longitudinal bundle of fibers, as pyramids, 
tracts, etc., connecting the gray matter of the spinal cord 
with all the brain centers. 

The ventricles of the brain are the spaces between the 
different ganglia or parts. 



DIAGRAM OF THE RELATIONS OF THE CENTRAL GANGLIA 
OF GRAY MATTER TO EACH OTHER AND TO THE 
SPINAL CORD. 

(C, C) Cortical gray matter of the cerebrum. 

(C, S) Corpus striatum. 

(N, L) Lenticular nucleus — the extra-ventricular part 
of former. 

(T, o) Optic thalamus. 

(V) Corpora quadrigemina. 

(P) Peduncle of cerebrum. 

(H) Tegmentum — the upper part of the peduncle. 
(P) Crusta—under part of peduncle. 

(i, i) Corona radiata of corpus striatum. 

(2,2) Corona radiata of lenticular nucleus. 

(3, 3) Corona radiata of the optic thalamus. 

(4, 4) Corona radiata of the corpora quadrigemina. 

(5) Direct fibers to cortex. 

(6, 6) Fibers from corpora quadrigemina to tegmentum. 
(7) Fibers of the optic thalamus. 

(m) Same fibers continued. 

(8, 8) Fibers from corpus striatum and nucleus to 
crusta. 

(M) Same continued in cord. 

(S, S) Course of sensory fibers. 

(a, a) Association system of fibers. 

(c, c) Commissural fibers. 

(R) Transverse section of spinal cord. 

(v, W) Anterior root. 

(lb W) Posterior root. 


237 


LEFT SIDE OF THE BRAIN, SHOWING THE FISSURES, CON¬ 
VOLUTIONS AND MOTOR AREAS, AND THEIR RELATION 

TO THE SKULL BONES AND THEIR SUTURES. 

The outer surface of the cerebral hemispheres is divided 
into four lobes by the fissure of Sylvius, the fissure of 
Rolando, and the parieto-occipital fissure. These, from 
their depth, regularity, and early development, are called 
primary fissures. The frontal lobe is that part anterior to the 
fissure of Rolando. The parietal lobe is between the fis¬ 
sure of Rolando and the parieto-occipital fissure. The 
occipital lobe consists of that part of the hemisphere below 
the parieto-occipital fissure. The temporo-sphenoidal lobe 
is that part which occupies the middle fosse of the skull, 
and is bounded before and above by the fissure of Sylvius 
and joins the occipital behind. The Island of Reil, or 
central lobe — the fifth primary lobe — lies deep in the fis¬ 
sure of Sylvius, but does not show on the surface. Each 
of these primary lobes is subdivided, by secondary fis¬ 
sures, of more or less regularity, into secondary lobules 
called convolutions. 

(Ki) Bregma. 

(K2) Parieto-frontal suture, crossing temporal ridge — 
the dotted semicircular line. 

(K3) Anterior inferior angle of parietal, joining the 
sphenoid and frontal bones, and where the suture begins. 

(M) Point on squamous suture crossed by a perpen¬ 
dicular line from depression in front of the meatus to the 

bregma. 

(Li,L 2) Parieto-occipital fissure. 

The numbers (1) to (24) and the letters (a), (b), (c), (d), 
referto cortical centers, and are the same as in description 
of following diagram. 


238 


(S) Main part of fissure of Sylvius, separating the 
frontal from the temporo sphenoidal lobes. It divides into 
an ascending, or perpendicular, and a horizontal ramus. 
The latter is bisected at the point (M). 

(C) Fissure of Rolando, or central sulcus. 

(A) Ascending frontal convolution. 

(B) Ascending parietal convolution. 

(f i) First or superior frontal fissure, corresponding to 
a curved line drawn parallel to the longitudinal fissure 
beginning at the supraorbital notch. 

(f 2) Second or inferior frontal fissure, a little below, 
but nearly corresponding to the temporal ridge. 

(f 3) Pre-central fissure — sometimes called an extension 
of the ascending ramus of the fissure of Sylvius. It cor¬ 
responds to the parieto-frontal suture, and is frequently 
joined at right angles by (f 1) the first, (f 2) second, and 
(f 3) third frontal convolutions. 

(i, p) Inter-parietal suture separating (P 1) superior 
parietal lobule or convolution from (P 2) inferior parietal 
lobule or convolution. The upper part of (P 2) is the 
supra-marginal convolution or gyrus, and the lower and 
posterior part is the angular convolution or gyrus. 

(c, m) End of calloso-marginal fissure. 

(P, o) Parieto-occipital fissure — the division between 
the parietal and occipital lobes — and nearly correspond¬ 
ing to the beginning of the occipito-parietal suture. 

(Li, L2) Points on the parieto-occipital suture. 

(o) Transverse occipital fissure. 

(o 2) Inferior or longitudinal occipital fissure. 

(Oi, O2, O3) First and third occipital convolutions, 
(t 1) First temporo-sphenoidal fissure—nearly parallel 
with horizontal branch of fissure of Sylvius, and nearly 
midway between it and 


239 


(t2) Second temporo-sphenoidal fissure. 

(Ti, T2, T3) First, second and third temporo-sphe¬ 
noidal convolutions. 

DIAGRAM OF UPPER SURFACE OF THE BRAIN. 

This plate shows three of the primary lobes: the frontal . 
with its four subdivisions — the first, second, third, and 
ascending frontal convolutions ; the parietal , with its four 
subdivisions — the ascending,' superior, supra-marginal, 
and angular convolutions ; the occipital , with its three 
convolutions — only the first and second appearing. 

The figured and lettered circles are the cortical areas, 
mapped out on the surface, corresponding to various cen¬ 
ters which have been located by the experiments and 
observations of Farrier and others. 

The motor areas in general are in close relation to the 
fissure of Rolando, especially in the ascending frontal 
and parietal convolutions. 

(1) On superior parietal lobule: centers for advancing 
opposite leg and foot, as in walking. 

(2, 3, 4) Around upper end of fissure of Rolando: 
centers for complex movements of arms, legs and trunk 
combined, as in climbing and swimming. 

(a, b, c, d) On the ascending parietal convolutions: 
the centers for fingers and wrist — prehensible. 

(5) Posterior end of first frontal convolution: for reach¬ 
ing out the arm and hand. 

(6) On the ascending frontal: for flexing and supin- 
ating forearm and hand — especially for the biceps. 

(7, 8) Middle of same convolution: for elevation and 
depression of the angle of the mouth. 

(9, 10) Broca’s convolution — the apliasiac region: for 
movements of lip and tongue. 


240 


(11) Between (10) and lower end of The ascending 
parietal: retraction of angle of mouth — the platysma. 

(12) Posterior parts of first and second frontal convo¬ 
lutions: for lateral movements of head and eyes, elevation 
of eyelids and dilatation of pupil. 

(13, 13) Supra-margitial and angular convolutions: 
centers of vision, with which the occipital lobe is also con¬ 
cerned. 

(14) On superior temporo-sphenoidal: for center of 
hearing. 

The center for smell is in the hippocampal lobule, not 
shown on the surface. Near by is the center of taste. 

The center for sense of touch is in the hippocampal 
region and gyrus fornicatus. 

CRANIOCEREBRAL TOPOGRAPHY — LANDMARKS AND 
RULES FOR LOCATING, ON THE SKULL OF THE LIV¬ 
ING SUBJECT, THE POSITION OF THE LOBES, PRIN¬ 
CIPAL BLOOD-VESSELS, FISSURES AND CONVOLU¬ 
TIONS OF THE BRAIN. 

(L) Lower border of orbit. 

(E) External angular process. 

(T) Beginning of temporal ridge. 

(S) Supra-orbital notch. 

(G) Glabella — prominence just above root of nose. 

(B) Bregma—junction of inter-parietal and fronto¬ 
parietal sutures. 

( + ) Center of parietal protuberance. 

(O) Occipital protuberance. 

(M) Posterior border of mastoid. 

(D) Depression in front of external auditory meatus. 

(H L) Horizontal base line from lower border of orbit 


241 


through middle of meatus to the occiput. Plain lines 
indicate position of primary fissures. Dotted lines, the 
secondary fissures or sulci. 

(a, b) Imaginary lines which arbitrarily mark the divis¬ 
ion between the parieto-occipital and temporo-sphenoidal 
lobes. 

The longitudinal fissure corresponds to the curved line 
(G O), and separates the hemispheres of the cerebrum. 

The transverse fissure (O D) is represented by a line 
from the occipital protuberance to the meatus, and corre¬ 
sponds to the superior curved line of the occipital bone, 
marking the separation of the occipital lobe from the 
cerebellum by the tentorium. 

The fissure of Sylvius is indicated by a line starting 
one and one-fourth inches behind the external angular pro¬ 
cess of the frontal bone (E), and ending three-fourths of an 
inch below the center of the parietal protuberance (+ ). 
The first three-fourths of an inch is the main fissure, at the 
end of which it divides into the ascending branch, which 
extends upward an inch from the horizontal branch just 
given. The division is beneath the anterior inferior angle 
of the parietal bone. The motor speech center is just in 
front of the vertical branch of this fissure. 

The fissure of Rolando. Draw the lines from (D) to the 
bregma (B) and from (M) to (F), perpendicular to the 
base line (H L). (F) can also be located by taking fifty- 

five and seven-tenths per cent, of the distance from (G) 
to (O). The fissure is represented by a line from (F) to 
the intersection of the fissure of Sylvius with the perpen¬ 
dicular line (D B). 

The parieto-occipital fissure is an inch long and at right 
angles to the longitudinal fissure. It is one-fourth of an 
inch in front of the junction of the lambdoidal and inter- 


242 


parietal sutures, and is about twenty-three per cent, of thv 
distance from (O) to (G). Also, if a line corresponding 
to the horizontal branch of the fissure of Sylvius were ex¬ 
tended to the longitudinal fissure, the last inch would 
represent the parieto-occipital fissure. 

These primary fissures divide the outer surface of the 
hemisphere into its four principal lobes, as follows. The 
frontal lobe , which is limited behind by the fissure of 
Rolando, and occupies the anterior fossse of the bones of 
the skull. It has on its surface three secondary fissures 
or sulci. The first frontal fissure is parallel with the 
longitudinal fissure, and midway between it and the tem¬ 
poral ridge beginning at the supraorbital notch (S). The 
second frontal fissure is approximately represented by the 
temporal ridge on the frontal bone. The precentral fis¬ 
sure begins just above the upper end of the vertical branch 
of the fissure of Sylvius, and extends half way to the longi¬ 
tudinal fissure. It lies beneath the fronto-parietal suture, 
or just behind it. The frontal convolutions are found be¬ 
tween these various fissures. 

The parietal lobe is limited, in part, by the fissure of 
Rolando in front, and the parieto-occipital fissure behind. 
Of its four convolutions, the ascending parietal lies behind, 
and parallel with, the fissure of Rolando ; the supra¬ 
marginal , around the upper end of the horizontal branch 
of the fissure of Sylvius; beneath the parietal eminence, 
and a little below it, the perpendicular line (M F) separates 
it from the angular cojivolution. 

The inter-parietal fissure is nearly indicated by a line 
starting on the fissure of Sylvius three-fourths of an inch 
behind the fissure of Rolando, running parallel with the 
longitudinal fissure, passing within one-half inch of the 
other end of the parieto-occipital fissure. 


243 


The occipital lobe is limited above by the parieto-occipital 
fissure extended as the curved line (a) to the end of the 
fissure of Sylvius. It is arbitrarily limited in front by the 
line (C) (b). 

The temporo-sphenoidal lobe lies in the middle fossae of 
the skull, and is bounded above by the fissure of Sylvius, 
its lower border corresponding to the zygoma, and a 
line continuing it to the superior curved line of the 
occipital bone. Its anterior limit is the posterior superior 
border of the malar bone. It is about one and five-eighths 
inches wide at the meatus. 

The first temporo-sphenoidal fissure is parallel with the 
fissure of Sylvius, and an inch below it. 

The second temporo-sphenoidal fissure is three-fourths 
of an inch below, and parallel with, the first. 

The posterior limit of the optic thalamus corresponds 
to the perpendicular line (M F). 

The anterior limit of the corpus striatum is a little in 
front of a vertical line from the beginning of the fissure of 
Sylvius. 

Of the fifteen cerebral venous sinuses only two are in 
such relations to the skull as to be of practical importance 
in trephining for traumatic or pathological conditions. 

One is the longitudinal sinus , which corresponds to the 
curved line (G) (O), but it is slightly to the left of the 
median line, and increases in width from before backward. 
The other is the lateral sinus , which is indicated by the 
line from (O) to the auditory meatus, and corresponds to 
the superior curved line of the occipital bone. It marks 
the inner surface of the tip of the posterior-inferior angle 
of the parietal bone. Hemorrhage from these sinuses is a 
serious complication of wounds, either operative or acci¬ 
dental. but, on account of the low blood-pressure in them, 


244 


is easily arrested by light pressure or fine cat-gut suture 
— the latter being difficult to apply in the midst of a free 
bleeding. 

The middle Meningeal artery is the chief supply 
of the skull and dura mater, and is the only artery to be 
avoided in operations on the skull. The only part of it 
likely to be wounded is its main branch, which corre¬ 
sponds to the middle of the anterior-inferior angle of the 
parietal bone, ascending behind but nearly parallel with 
the fronto-parietal suture. The next large branch is hor¬ 
izontal, and corresponds nearly with the second temporo- 
sphenoidal fissure (which see). Hemorrhage from these 
branches is annoying, but usually not serious, as it can 
generally be arrested by the usual means — forci-pressure 
is often the best means. Still, they are to be avoided in 
operations, when possible. 


THE EYE. 

The organ of vision consists, of the Globe and its pro¬ 
tective organs, as the Eyelids and the Lachrymal Appa¬ 
ratus. 

The eyelids are two elliptical structures consisting of 
strata of different tissues. The strata are : 

I. The skin. 

II. The orbicularis muscle (4), which closes the lids, 
is of thin, pale fibers, and supplied by the facial nerve as 
one of the muscles of expression. A thicker part of this 
muscle surrounds the borders of the orbit. 

TII. The tarsal cartilage , which is a rigid plate of con¬ 
nective tissue held in place by the tarsal ligaments, which 
extend from their outer border to the periosteum of the 



2 45 


orbit, and which prevent pus, in suppuration of the lid, 
from passing back into the orbit. 

IV. The expanded tendon of the levator ftalpebrce 
(upper lid only). 

V. Meibomian ( sebaceous ) glands , (2) whose ducts open 
on the free margins of the lid, (3) the fatty secretion of 
which prevents the overflow of tears. 

VI. Mucous membrane {conjunctiva) , which secretes 
some mucus, and forms the posterior layer of the eyelid. 

The eyelids contain no fat, but the different strata are 
held together by delicate areolar tissue. The upper lid 
is the larger and more movable. The interval between 
the two lids is th e palpebral fissure. The junction of the 
lids, at the ends of the fissure, makes the inner canthus 
and the outer canthus. Near the inner canthus each lid 
has a papilla, in which is a small opening to receive tears, 
th punctinn lachrymale (5). 

The tear apparatus consists of the lachrymal gland (1), 
situated below the external angular process of the frontal 
bone, and whose excretory ducts (eight to ten) perforate 
the conjunctiva on the under surface of the upper lid ; 
the puncta (5), which are the outer openings of the cana- 
liculi (6) (upper and lower), which join to form the lach¬ 
rymal sac , from which passes downward (7) the nasal 
duct , opening into the inferior meatus of the nose, toward 
the front. The upper canaliculus first ascends vertically, 
dilates into a small pouch, and then runs, a quarter of an 
inch, transversely. The lower descends vertically at first, 
and is shorter and thicker. The nasal duct is three-fourths 
of an inch in length, and is directed downward, backward 
and slightly outward. 

The globe is held in its place in the orbit chiefly by 
the four recti muscles (8), which, with the two oblique , 


246 


move it on its posterior cushion of fat, as a ball and socket 
joint. 

(9) Junction of cornea with (10) sclerotic , which pos¬ 
teriorly is continuous with the fibrous covering 1 of the 
optic nerve derived from the dura mater. 

(11) Iris , which contains two muscles — the circular 
(sphincter), which surrounds the pupil, lying near the pos¬ 
terior surface, and is supplied by the third nerve; and the 
radiating muscle ( dilator ), which is chiefly supplied by 
the sympathetic. The iris is suspended in the fluid 
(aqueous humor) which fills the space between the cornea 
and the lens. The space in front, the anterior chamber, 
connects through the pupil with the posterior chamber. 

(12) Ciliary processes , radiating folds of the choroid 

(13), sixty or seventy in number. The ciliary muscle 
(muscle of accommodation) is a ring of unstriped fibers 
placed at junction of iris and choroid between the ciliary 
processes and the sclerotic. 

(14) The retina , the expansion of (15) the optic \ 

nerve. 


THE EAR. 

The organ of hearing consists of the outer cartilaginous 
part, the Pinna; the External Auditory Meatus; the Tym¬ 
panum or Middle Ear; and the Labyrinth or Internal Ear, 
comprising the Vestibule, Cochlea, and Semicircular 
Canals. The pinna is composed of yellow fibro-cartilage, 
and has a tubular prolongation inward to form a part of 
the meatus. 

(1) A sectional view of the bony part of the external 
auditory meatus. The whole canal is one inch and a 
quarter in length, the cartilaginous portion forming a little 



247 


less than one-third. The narrowest part of the canal is 
about its middle. Hence the difficulty of extracting for¬ 
eign bodies which get beyond this constriction. The 
direction of the canal is, at first, inward, forward, and 
upward; then it curves slightly downward. The floor is 
a little longer than the roof, owing to the tympanic mem¬ 
brane being placed obliquely. 

(2) The membrana tympani , a thin, semi-transparent, 
membranous disc, slightly oval in shape, forming a com¬ 
plete partition between the external auditory canal and 
the middle ear. It has a thin layer of true skin on its 
outer surface. Its inner surface is lined with the 
mucous membrane of the tympanum. It is supplied with 
sensation, in connection with the auditory canal, by a branch 
from the auriculo-temporal of the third division of the 
trifacial. 

(3) Inner surface of membrana tympani, against the 
upper half of which lies, vertically, the handle of the 
malleus (4). 

( 5 ) The incus or anvil bone. 

(6) The stapes , or stirrup bone, the base of which is 
attached to the membrane of the fenestra ovalis on the 
inner wall of the cavity of the tympanum. From the 
anterior wall of this cavity the Eustachian tube leads 
downward, forward and inward to the pharynx. On the 
posterior wall are three or four openings which convey air 
to the mastoid cells. 

The internal ear consists of (7) the three semicircular 
canals behind; in front, (8) the cochlea; and the vesti¬ 
bule, a small cavity placed between (7) and (8). 

(9) Termination of the auditory nerve in the cochlea. 

The cochlea is in the form of a snail shell. Its base, 

one-fourth of an inch in diameter, corresponds to the bot- 
12 


JUN 11 1W0 



248 


tom of the internal auditory meatus — the apex being 
directed outward and forward. 

The auditory nerve, the portio mollis of the seventh 
pair, after passing down through the internal auditory 
meatus, divides into two sets of branches, the anterior 
being distributed in the cochlea, the posterior in the 
vestibule. 




























































































